Article Figures & Data
Figures
- Fig 1.
Scatterplot of nTBF determined by arterial spin-labeled perfusion imaging and %Vessel determined by histopathologic examination with regression lines in 11 patients with nonfunctioning pituitary macroadenomas. The correlation between normalized tumor blood flow and %Vessel is statistically significant (P < .05) (Spearman rank-order correlation).
- Fig 2.
Nonfunctioning pituitary macroadenoma with hypovascularity in a 34-year-old woman (case 8). A, Coronal postcontrast fat-suppressed T1WI (TR/TE/NEX = 600 ms/9.4 ms/2) by using a 1.5T scanner shows a strongly enhanced pituitary tumor (arrow) (degree of enhancement = 1.88). B, Arterial spin-labeled perfusion imaging (TR/TE/NEX = 4594 ms/10.6 ms/3; postlabel delay = 1525 ms; section thickness = 3.8 mm) by using a 3T scanner shows a relatively low signal intensity at the pituitary tumor (arrow) (TBF = 59.5 mL/min/100 g, nTBF = 0.73). nTBF = TBF/(Right Cerebellar CBF + Left Cerebellar CBF)/2. The CD-31-immunostained histopathologic specimen (C) and the black on the vessel wall area (D) indicate low microvascular density (%Vessel = 1.2%).
- Fig 3.
Nonfunctioning pituitary macroadenoma with hypervascularity in a 72-year-old man (case 1) in whom a postoperative symptomatic hemorrhage with visual deterioration required an emergent reoperation to resolve the visual disturbance. A, Coronal postcontrast fat-suppressed T1WI (TR/TE/NEX = 600 ms/9.4 ms/2) by using a 1.5T scanner shows a strongly enhanced pituitary tumor (arrow) (degree of enhancement = 1.48). B, Arterial spin-labeled perfusion imaging (TR/TE/NEX = 4594 ms/10.6 ms/3; postlabel delay = 1525 ms; section thickness = 3.8 mm) by using a 3T scanner shows a relatively high signal intensity at the pituitary tumor (arrow) (TBF = 94.4 mL/min/100 g, nTBF = 1.94). nTBF = TBF/(Right Cerebellar CBF + Left Cerebellar CBF)/2. The CD-31-immunostained histopathologic specimen (C) and the black on the vessel wall area (D) indicate high microvascular density (%Vessel = 24%).
Tables
Summary of patient characteristics, histopathologic findings, tumor volume and enhancement, microvessel density, and intra- and postoperative hemorrhages in 11 patients with nonfunctioning pituitary macroadenomas
Case/Age (yr)/Sex Initial/Recurrence Histopathology Tumor Volume (cm) Degree of Enhancement of Tumor ASL-PI nTBF ASL-PI TBF (mL/min/100 g) CD-31 %Vessel Intraoperative Vascularity Findings Postoperative Hemorrhage 1/72/M Initial SGA 11.4 1.48 1.94 94.4 24.0 (+) (+)a 2/52/M Recurrence NCA 8.7 1.50 0.47 29.5 1.3 (−) (−) 3/63/M Initial SGA 4.7 1.36 0.96 22.7 0.7 (−) (−) 4/48/F Recurrence SGA 2.2 1.44 0.75 51.0 1.7 (−) (−) 5/54/M Initial SGA 6.0 1.71 1.88 74.2 17.0 (+) (+) 6/69/M Recurrence NCA 7.7 1.81 0.72 26.6 2.6 (−) (−) 7/60/F Initial NCA 2.8 1.27 0.51 38.0 1.1 (−) (−) 8/34/F Initial SGA 4.9 1.88 0.73 59.5 1.2 (−) (−) 9/68/M Recurrence NCA 3.4 1.82 0.76 26.6 2.6 (−) (−) 10/60/F Initial NCA 9.9 1.68 2.45 102.6 19.0 (+) (+) 11/67/M Recurrence SGA 4.7 1.96 1.03 46.2 6.4 (−) (−) Note:—SGA indicates gonadotroph adenoma; NCA, null cell adenoma; ASL-PI nTBF, tumor blood flow normalized to the cerebellum measured with ASL-PI; ASL-PI TBF, absolute tumor blood flow (milliliters per minute per 100 g) measured with ASL-PI; (−), hypovascular; +, hypervascular.
↵a Symptomatic hemorrhage.
