title: Uneven Distribution of Regional Blood Supply Prompts the Cystic Change of Pituitary Adenoma.
abstract: BACKGROUND
  Previous studies have suggested that the cystic change of pituitary adenoma might be related to the blood supply and metabolism of the tumor; however, the exact pathologic mechanism underlying the cystic change remains unknown.
  
  
  OBJECTIVE
  We aimed to assess the features of regional blood supply of pituitary adenoma and examine its relationship with the cystic change of pituitary adenoma.
  
  
  METHODS
  Patients (N = 79) with pituitary adenoma admitted to our hospital were divided into the parenchyma group (n = 40) or the cystic change group (n = 39). Dynamic contrast-enhanced magnetic resonance imaging of the pituitary adenoma was conducted for the parenchyma group and the steepest slopes (SSmax, reflecting regional blood supply) at different areas were calculated. The location of cystic change of the pituitary adenoma was recorded and analyzed for the cystic change group.
  
  
  RESULTS
  The parenchyma group showed an upper SSmaxof 2.52 ± 1.18, a lower SSmaxof 2.89 ± 1.46, a left SSmaxof 2.71 ± 1.31, and a right SSmaxof 2.66 ± 1.29. The difference between the upper and lower SSmaxwas statistically significant (P < 0.001), with no difference between the left and right regions (P = 0.668). The location of cystic change of the pituitary adenoma was mainly in the upper region, accounting for 48.7% of cases.
  
  
  CONCLUSIONS
  Regional blood supply is unevenly distributed in the parenchymal pituitary adenoma, with reduced blood supply in the upper than the lower region. Cystic change mainly occurs in the upper region of pituitary adenoma.
authors.affiliation: Department of Neurosurgery, Fuzong Clinical College, Fujian Medical University, Fuzhou, P.R. China.
authors.forename: Jianhe
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Fuzong Clinical College, Fujian Medical University, Fuzhou, P.R. China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Gu
authors.affiliation: Department of Neurosurgery, Fuzong Clinical College, Fujian Medical University, Fuzhou, P.R. China.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Neurosurgery, Fuzong Clinical College, Fujian Medical University, Fuzhou, P.R. China.
authors.forename: Yinxing
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, Fuzong Clinical College, Fujian Medical University, Fuzhou, P.R. China.
authors.forename: Jiaxing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Fuzong Clinical College, Fujian Medical University, Fuzhou, P.R. China.
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Fuzong Clinical College, Fujian Medical University, Fuzhou, P.R. China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Zhong
authors.affiliation: Department of Neurosurgery, Fuzong Clinical College, Fujian Medical University, Fuzhou, P.R. China. Electronic address: leo200303034@126.com.
authors.forename: Shousen
authors.initials: S
authors.lastname: Wang
mesh_terms: D000236:Adenoma / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007238:Infarction / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D055420:Perfusion Imaging; D010911:Pituitary Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012039:Regional Blood Flow; D047368:Tumor Burden
keywords: Cystic change; Dynamic contrast-enhanced MRI; Infarction; Pituitary adenoma; Tumor blood supply