MRI 3D SPACE T2WI for Pituitary Adenoma Cavernous Sinus Invasion Diagnosis

Objective This study aims to assess the utility of MRI 3D SPACE T2WI sequences in evaluating cavernous sinus invasion by pituitary adenomas. Materials and methods Data were collected from patients who underwent continuous pituitary MRI examinations at the Medical Imaging Center of our hospital from October 2019 to February 2021. Eligible cases were evaluated for sagittal and axial T1WI sequences, coronal 3D SPACE T2WI sequences, and sagittal and coronal enhanced T1WI sequences using the INFINITT PACS workstation. The Wilcoxon signed-rank test for paired samples and the Mann–Whitney U test for two independent samples were used to statistically analyze differences in image quality scores among various groups. In addition, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each observation index were compared with intraoperative results. Results 3D SPACE T2WI showed superior cavernous sinus imaging quality compared with CE T1WI and T2WI plain scans (P<0.05). The sensitivity, specificity, PPV, and NPV were 100%, 90.0%, 55.60%, and 100.0%, respectively. The accuracy for pituitary adenoma invasiveness diagnosis based on cavernous sinus medial wall integrity was 94.40%. Conclusion The imaging quality of the medial wall of the cavernous sinus on the 3D SPACE T2WI plain scan sequence surpassed that of CE T1WI TSE-enhanced scans and T2WI TSE plain scans. The continuous observation of the medial wall of the cavernous sinus using this sequence holds great diagnostic value for assessing cavernous sinus invasion by pituitary adenomas. This strategy is more reliable than traditional MRI observation indicators.