Dynamic gadolinium-enhanced MR imaging of pituitary adenomas: usefulness of sequential sagittal and coronal plane images

Dynamic magnetic resonance (MR) imaging for pituitary adenomas is usually p erformed in a coronal direction; however, small lesions between slices, or lesions located at the anterior or posterior aspect of the pituitary gland might be overlooked on MR images in only the coronal direction. The purpose of our study was to evaluate whether consecutive dynamic MR images in the coronal and sagittal planes improve detection of pituitary adenomas. Eighte en patients with pituitary microadenomas and nine with healthy pituitary gl ands were included in this study. MR images were performed with 1.5 T super conductive units and commercially-available head coils. After a 5 ml gadoli nium contrast injection, eight serial dynamic sagittal images were obtained . Within 3 or 6 min, this was followed by a 10-15 ml gadolinium injection a nd acquisition of eight serial dynamic coronal images. Dynamic MR images an d conventional noncontrast- and contrast-enhanced sagittal and coronal T1-w eighted images were evaluated independently in a blind fashion by two neuro radiologists regarding the depiction of pituitary microadenomas. The sensit ivities of dynamic enhanced MR imaging in the detection of microadenomas we re 61.1% in sagittal direction, 72.2% in coronal direction respectively, an d were superior to those of conventional noncontrast- and contrast-enhanced T1-weighted imaging (22.2-50%). The sensitivity of a combination of sagitt al and coronal dynamic enhanced MR imaging for the detection of microadenom as was 88.9% and was superior to those of conventional noncontrast- and con trast-enhanced T1-weighted imaging combining sagittal and coronal direction s (61.1%, 61.1%) (P<0.05, P<0.05, respectively). The specificity and accura cy of dynamic enhanced MR imaging with combination of sagittal and coronal images was 88.9% respectively. Dynamic gadolinium-enhanced MR imaging, espe cially using both sagittal and coronal planes, was concluded to be useful f or the detection of pituitary microadenomas. (C) 2001 Elsevier Science Irel and Ltd. All rights reserved.