ROLE OF CONVENTIONAL T2 AND DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN PREOPERATIVE EVALUATION OF PITUITARY MACROADENOMA CONSISTENCY

Abstract

INTRODUCTION:Pituitary macroadenomas are typically benign tumors, that are composed of glandular tissue growth larger than 10 mm in the pituitary gland. Most are noncancerous.The pituitary macroadenomas were divided into three groups based on the surgical viewpoint and histology of the tumor consistency: soft, intermediate, and hard.The preoperative assessment of pituitary macroadenoma tumor consistency is crucial for neurosurgery in order to determine which surgical approach-transsphenoidal or transcranial-is the best. Tumors with a soft consistency can be removed by suction using the transsphenoidal approach, whereas those with a harder consistency are more fibrous and more difficult to remove through suction and curettage, which suggests the use of the transcranial approach.Tumor cellularity and consistency can be evaluated noninvasively using apparent diffusion coefficient (ADC) mapping and diffusion-weighted imaging (DWI).Our hypothesis was that we could predict consistency and successfully standardize MR signals to a consistent anatomical landmark using ratios of adenoma to cerebellar peduncle signal intensity on MR T2-weighted imaging.AIM OF THE WORK:The aim of this study was to evaluate the role of diffusion weighted MR imaging (DWI) and T2 signal in the preoperative evaluation of pituitary macroadenoma consistency.