LAUSR

OBJECTIVE Cushing disease is a potentially fatal endocrine disorder caused by adrenocorticotropin (ACTH) -secreting microadenomas in the pituitary gland. Accurate detection and localization of the adenomas is the key to clinical treatment. This study analyzed the value of contrast-enhanced SPACE sequence in MRI assessment of ACTH-secreting pituitary microadenomas. DESIGN AND PATIENTS We carried out a retrospective study in which 45 patients with ACTH-secreting pituitary microadenomas were enrolled. DCE coronal T1-SE sequence was performed. Contrast enhanced coronal SPACE sequence was added immediately after DCE MRI finished. Two independent observers assessed the tumor existence and location, then the results were compared with surgical findings. RESULTS 24 lesions (53.3%) were detected by DCE T1-SE sequence alone, while 35 lesions (80.0%) were detected with addition of contrast enhanced SPACE sequence. The sensitivity (58.5% vs. 85.3%; P<0.05) and best diagnostic accuracy (62.0% vs. 84.4%; P<0.05) were significantly better for addition with SPACE sequence than DCE-SE images alone in detection of ACTH-secreting pituitary microadenomas. For lesions less than 5mm, the detected number were 4 (16.6%) vs. 10 (27.8%) by DCE T1-SE sequence and combined DCE T1-SE with SPACE sequence. CONCLUSIONS Combination of contrast-enhanced SPACE with DCE T1-SE sequence could improve the detection of ACTH-secreting pituitary microadenomas. Contrast-enhanced SPACE sequence could be a supplementary sequence for imaging of ACTH-secreting pituitary adenomas when T1-SE sequence provides negative or equivocal findings. This article is protected by copyright. All rights reserved.