Poster (9)
1
RESULTS Comparison between Dynamic contrast SE MRI and contrast enhanced VIBE MRI detection of microadenoma Finding Contrast enhanced VIBE Negative Suspicious Positive Total Dynamic contrast (Spin Echo) Negative 2 2 4 Suspicious 3 3 6 Positive 12 12 Total 2 3 17 22 *Six patients with macroadenomas visible on both MRI techniques were not included in the final analysis. Comparative images of 3 patients using both techniques CONCLUSION Post contrast VIBE-MRI technique is superior to conventional dynamic contrast SE-MRI technique for detection of pituitary microadenoma in Cushing’s disease. Sensitivity of Dynamic SE MRI : 55% Sensitivity of VIBE MRI : 77% BACKGROUND Imaging microadenomas in Cushing’s disease (CD) is a challenge: Yield of Pituitary MRI in detecting microadenomas is < 60%. Can VIBE technique offer a solution? • Based on Radio-frequency spoiled 3D GRE sequence, it takes up to 1 mm thin sections which can be useful for detecting small pituitary microadenomas • Uses partial fourier of zero filling in slice selection that improves spatial resolution • Provides faster acquisition, minimizes artifacts due to motion and vascular pulsation OBJECTIVE To compare the performance of dynamic contrast SE MRI technique and contrast enhanced VIBE technique in the diagnostic evaluation of ACTH secreting microadenomas in CD PATIENTS AND METHODOLOGY • 28 patients (21 F and 7 M) with ACTH dependent endogenous hypercortisolism and final diagnosis of CD (based on histopathology proof of adenoma and/or remission (partial/ complete) of hypercortisolism post surgery) treated over 2 yrs were included. • All patients underwent MRI imaging by both techniques simultaneously. • Cases with negative pituitary MRI underwent bilateral IPSS as a proof for pituitary origin of ACTH excess state. • Images were reviewed retrospectively by two independent radiologists who were blinded to clinical details and final diagnosis. Kasaliwal R Contrast Enhanced Volumetric Interpolated Breath Hold Examination (VIBE) Technique is Better than Dynamic Contrast Spin Echo Technique for MRI Detection of ACTH Secreting Pituitary Microadenomas *Kasaliwal R, Lila AR, Sarathi V, Jagtap VS, Budyal S, Bandgar TR, Menon PS, Shah NS Department of Endocrinology, Seth G.S. Medical College and King Edward Memorial Hospital, Parel, Mumbai, India *Email: [email protected] a-SE b-VIBE 1a 1b 2a 2b 3a 3b
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Transcript of Poster (9)
RESULTSComparison between Dynamic contrast SE MRI and
contrast enhanced VIBE MRI detection of microadenoma
FindingContrast enhanced VIBE
Negative Suspicious Positive Total
Dynamic contrast
(Spin Echo)
Negative 2 2 4
Suspicious 3 3 6
Positive 12 12
Total 2 3 17 22
*Six patients with macroadenomas visible on both MRI techniques were not included in the final analysis.
Comparative images of 3 patients using both techniques
CONCLUSIONPost contrast VIBE-MRI technique is superior to conventional dynamic contrast SE-MRI technique for detection of pituitary microadenoma in Cushing’s disease.
Sensitivity of Dynamic SE MRI : 55%Sensitivity of VIBE MRI : 77%
BACKGROUND
Imaging microadenomas in Cushing’s disease (CD) is a
challenge: Yield of Pituitary MRI in detecting microadenomas is
< 60%.
Can VIBE technique offer a solution?
• BasedonRadio-frequencyspoiled3DGREsequence,ittakes
up to 1 mm thin sections which can be useful for detecting
small pituitary microadenomas
• Uses partial fourier of zero filling in slice selection that
improves spatial resolution
• Providesfasteracquisition,minimizesartifactsdue to motion
and vascular pulsation
OBJECTIVE
To compare the performance of dynamic contrast SE MRI
technique and contrast enhanced VIBE technique in the
diagnostic evaluation of ACTH secreting microadenomas in CD
PATIENTS AND METHODOLOGY
• 28patients(21 F and 7 M) with ACTH dependent endogenous
hypercortisolism and final diagnosis of CD (based on
histopathology proof of adenoma and/or remission (partial/
complete) of hypercortisolism post surgery) treated over
2 yrs were included.
•All patients underwent MRI imaging by both techniques
simultaneously.
•Caseswith negative pituitaryMRI underwentbilateral IPSS
as a proof for pituitary origin of ACTH excess state.
• Images were reviewed retrospectively by two independent
radiologists who were blinded to clinical details and final
diagnosis. Kasaliwal R
Contrast Enhanced Volumetric Interpolated Breath Hold Examination (VIBE) Technique is Better than Dynamic Contrast Spin Echo Technique for MRI Detection of ACTH Secreting Pituitary Microadenomas*Kasaliwal R, Lila AR, Sarathi V, Jagtap VS, Budyal S, Bandgar TR, Menon PS, Shah NSDepartment of Endocrinology, Seth G.S. Medical College and King Edward Memorial Hospital, Parel, Mumbai, India *Email: [email protected]
a-SEb-VIBE
1a
1b
2a
2b
3a
3b
