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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한자기공명의과학회 Investigative Magnetic Resonance Imaging Investigative Magnetic Resonance Imaging 제22권 제2호
- 발행연도
- 2018.1
- 수록면
- 102 - 109 (8page)
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Purpose: The purpose of this study is to compare the performance of the T1 3D subtraction technique and the conventional 2D dynamic contrast enhancement (DCE) technique in diagnosing Cushing’s disease. Materials and Methods: Twelve patients with clinically and biochemically proven Cushing’s disease were included in the study. In addition, 23 patients with a Rathke’s cleft cyst (RCC) diagnosed on an MRI with normal pituitary hormone levels were included as a control, to prevent non-blinded positive results. Postcontrast T1 3D fast spin echo (FSE) images were acquired after DCE images in 3T MRI and image subtraction of pre- and postcontrast T1 3D FSE images were performed. Inter-observer agreement, interpretation time, multiobserver receiver operating characteristic (ROC), and net benefit analyses were performed to compare 2D DCE and T1 3D subtraction techniques. Results: Inter-observer agreement for a visual scale of contrast enhancement was poor in DCE (κ = 0.57) and good in T1 3D subtraction images (κ = 0.75). The time taken for determining contrast-enhancement in pituitary lesions was significantly shorter in the T1 3D subtraction images compared to the DCE sequence (P < 0.05). ROC values demonstrated increased reader confidence range with T1 3D subtraction images (95% confidence interval [CI]: 0.94-1.00) compared with DCE (95% CI: 0.70- 0.92) (P < 0.01). The net benefit effect of T1 3D subtraction images over DCE was 0.34 (95% CI: 0.12-0.56). For Cushing’s disease, both reviewers misclassified one case as a nonenhancing lesion on the DCE images, while no cases were misclassified on T1 3D subtraction images. Conclusion: The T1 3D subtraction technique shows superior performance for determining the presence of enhancement on pituitary lesions compared with conventional DCE techniques, which may aid in diagnosing Cushing’s disease.
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참고문헌 (43)
참고문헌 신청
Juszczak A / 2013 / The management of Cushing's disease - from investigation to treatment / Endokrynol Pol 64:166~174
Newell-Price J / 1998 / The diagnosis and differential diagnosis of Cushing's syndrome and pseudo-Cushing's states / Endocr Rev 19:647~672
Potts MB / 2014 / Cavernous and inferior petrosal sinus sampling and dynamic magnetic resonance imaging in the preoperative evaluation of Cushing's disease / J Neurooncol 116:593~600
Witek P / 2012 / Predictive value of preoperative magnetic resonance imaging of the pituitary for surgical cure in Cushing's disease / Turk Neurosurg 22:747~752
Davis WL / 1994 / Dynamic contrast-enhanced MR imaging of the pituitary gland with fast spin-echo technique / J Magn Reson Imaging 4:509~511
Newell-Price J / 1998 / The diagnosis and differential diagnosis of Cushing's syndrome and pseudo-Cushing's states / Endocr Rev 19:647~672
Potts MB / 2014 / Cavernous and inferior petrosal sinus sampling and dynamic magnetic resonance imaging in the preoperative evaluation of Cushing's disease / J Neurooncol 116:593~600
Witek P / 2012 / Predictive value of preoperative magnetic resonance imaging of the pituitary for surgical cure in Cushing's disease / Turk Neurosurg 22:747~752
Davis WL / 1994 / Dynamic contrast-enhanced MR imaging of the pituitary gland with fast spin-echo technique / J Magn Reson Imaging 4:509~511
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