Dynamic and conventional spin-echo MR of pituitary microlesions.

PURPOSE To determine whether dynamic traditional spin-echo MR imaging, with the use of routine T1 parameters during contrast infusion, is superior to standard MR imaging after contrast administration for detecting microlesions of the pituitary gland.

METHODS Sixty-four patients with pituitary microlesions 3 to 10 mm in diameter were examined with a dynamic traditional spin-echo technique; that is, a typical T1 spin-echo sequence of 500-600/20-25/2 (repetition time/echo time/excitations), 3-mm-thick sections, 16-cm field of view, 256 x 128 matrix, and a scan time ranging from 2 minutes to 2 minutes 40 seconds during contrast infusion. In addition, standard imaging with unenhanced and contrast-enhanced spin-echo sequences were obtained. The three sequences were evaluated retrospectively and graded for gland-lesion contrast conspicuity, lesion homogeneity, and delineation of lesion margin.

RESULTS The dynamic sequence was judged to be better than the standard enhanced sequence for depicting microlesions in 42% to 47% of patients. Lesions were identified only on the dynamic study in an additional 1% to 14% of patients. Lesions were seen equally well on the standard and dynamic sequences only in 16% to 23% of cases. The standard postcontrast sequence was judged better in 12.5% to 17% of cases, with lesions identified only on the standard sequence in an additional 8% to 9%.

CONCLUSION Dynamic traditional spin-echo MR imaging improved lesion detection and provided increased clarity over standard sequences after contrast infusion. Both sequences are important, since lesions were detected only on the dynamic sequence in 11% to 14% of patients and only on the standard sequence in 8% to 9% of patients.