POSTOPERATIVE SELLA - EVALUATION WITH FAST SPIN-ECHO T2-WEIGHTED HIGH-RESOLUTION IMAGING

OBJECTIVE: The purpose of this study was to investigate the magnetic r esonance features of the postoperative sella with fast spin echo (FSE) T2-weighted high-resolution imaging and to evaluate the benefits of t he sequence using a follow-up magnetic resonance imaging protocol afte r transsphenoidal surgery. METHODS: Coronal spin echo (SE) T1-weighted and FSE T2-weighted images were prospectively obtained in 24 patients after surgery for pituitary adenomas. We observed the signals and the contour of normal structures, fluid collection, implanted materials, and mass lesions, including granulation tissue and adenoma.RESULTS: Th e pituitary gland was delineated in 51 of 59 FSE T2-weighted images, 9 0.2% of which presented clear boundaries. Whereas the gland was detect ed in 49 of 58 SE T1-weighted images, only 20.4% showed the boundaries . A mass lesion was identified in each of 12 patients with good resolu tion on FSE T2-weighted images. SE T1-weighted images detected mass le sions in 7 of 12 patients without distinctive boundaries. Contrast enh ancement had little advantage in clarifying the boundaries between nor mal and abnormal structures. For the detection of mass lesions in the sella, the kappa values for interobserver agreement were 0.8 for FSE T 2-weighted images and 0.25 for SE T1-weighted images. CONCLUSION: FSE T2-weighted imaging is a reliable method with which to assess the sell a with sufficient resolution after transsphenoidal surgery. The combin ation of unenhanced SE T1-weighted and FSE T2-weighted images may redu ce the use of contrast material after pituitary surgery.