Quiet T1-weighted imaging using PETRA: initial clinical evaluation in intracranial tumor patients.

PURPOSE: To compare the lesion contrast and signal to noise ratio (SNR) obtained with T1-weighted pointwise encoding time reduction with radial acquisition (PETRA) to those of Magnetization-Prepared RApid Gradient-Echo (MPRAGE) for contrast-enhanced imaging of primary and metastatic intracranial tumors, and to investigate whether PETRA is able to reduce acoustic noise for improved patient comfort. MATERIALS AND METHODS: Fifteen patients with intracranial tumors underwent 3 Tesla MRI including inversion-prepared PETRA and MPRAGE. The two sequences had comparable scan times, spatial resolution and spatial coverage. "Tumor conspicuity" was rated qualitatively by two radiologists, while enhancing lesion-to-white matter contrast to noise ratio (CNR) and white-matter SNR were analyzed quantitatively using paired t-tests. The acoustic noise generated by each sequence was measured. RESULTS: Qualitative rating of "tumor conspicuity" by two radiologists resulted in nearly identical average scores for the two sequences. Quantitative analyses revealed that (i) there was no significant difference between the mean CNR values of the two sequences (P = 0.57), (ii) the mean SNR of PETRA was significantly higher than that of MPRAGE (P < 0.01), and (iii) the mean sound level of PETRA was significantly lower than that of MPRAGE (P < 0.01). CONCLUSION: Inversion-prepared PETRA was found to be viable as a quiet alternative to MPRAGE for contrast-enhanced T1-weighted studies of intracranial tumors.

Use of high-field intraoperative magnetic resonance imaging during endoscopic transsphenoidal surgery for functioning pituitary microadenomas and small adenomas located in the intrasellar region.

The usefulness of 1.5-T high-field intraoperative magnetic resonance (iMR) imaging during transsphenoidal surgery for functioning pituitary adenomas was retrospectively evaluated based on long-term endocrine remission from the records of 14 patients who underwent transsphenoidal surgery with iMR imaging for functioning pituitary microadenomas and small adenomas located in the intrasellar region. The maximum tumor diameter was 9.3 ± 2.6 mm. Patients were diagnosed with acromegaly (n = 7), prolactinoma (n = 4), and Cushing's disease (n = 3). If iMR imaging detected tumor remnants after resection, the resection cavity was reexamined and further resection was performed. Postoperative endocrine follow-up period was mean 33.7 ± 13.3 months. Tumor remnants were detected after the first resection in seven patients. Further resection was performed in five of these patients, and three achieved long-term endocrine remission. As a result, the overall long-term endocrine remission rate was 78.5% (11/14), instead of the 57.1% (8/14) that would be expected if iMR imaging had not been performed. Long-term endocrine remission had a tendency to be associated with the absence of tumor remnants on the final iMR images, but this was not significant (p = 0.09). Long-term endocrine remission was associated with presence of tumor remnants in the cavernous sinus on the final iMR images (p = 0.03). High-field iMR imaging is useful for depicting tumor remnants after resection, and increased the long-term endocrine remission rate for patients with functioning pituitary microadenomas and small adenomas.