Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2017
Student: AYNUR SAMADOVA
Supervisor: MURAT UÇAR
Abstract:PURPOSE: To evaluate the necessity of the early postoperative MRI and contrast material used in routine in patients who underwent resection of pituitary tumors and were perfomed pre-operative (maximum 1 month before surgery), early postoperative (first 48 hours), and late postoperative (3.month) MR studies in our department. MATERIAL AND METHOD: The study group consisted of 101 patients who underwent resection of pituitary tumors and we evaluate pre-operative (maximum 1 month before surgery), early postoperative (first 48 hours), and late postoperative (3.month) 303 MRI of this patients in total. The cases were interpretated by two radiologists with 4.5-year and 15-year experience using the following criteria for assessing residual tumor: 1-definitive non visible, 2-most probable non visible, 3-most probable visible, 4-definitive visible). The early postoperative T2A and postcontrast T1A images were compared with each other and with late T2A and postcontrast T1A images to assess the level of agreement. At the same time, the relationship between the preop size of the lesion and the visibility of the residual tumor in postoperative images was investigated. İn addition for evaluating the contribution of the detailed examination of preoperative images to the interpretation of early postoperative MRIs, postop scans interpreted alone at the first session, then with preoperative images in second session. The results of the two sessions were compared. RESULTS: Significant correlation was found between early postoperative postcontrast T1A images and late postcontrast T1A images, but no significant correlation was found between T2A examinations. Furthermore, although there was a statistically significant difference between the early postoperative T2A interpretations assessed alone and with preoperative images, there was no significant difference between the interpretations of the postcontrast T1A images. There was a significant relationship between the preop size of the lesion and the visibility of the residual tumor in postoperative images. It was also found that the lesion size correlated with the difference between postop T2A and T1A image interpretation. CONCLUSION: The information we have obtained about the acquisition time of postoperative MRI is largely similar to other studies in the literature. Early postoperative MRI provide accurate and reliable information in differentiating residual tumor from postoperative surgical changes. Early postoperative period postcontrast T1A images are more valuable in detection of residual tumor than T2A images. At the same time, the contrast material used in early MRI is largely useful, especially for detecting the residual tumor of microadenomas. In addition, detailed examination of the preoperative images significantly affects interpretation in the early postoperative period, especially of T2A images.