Evaluation of pituitary structures and lesions with turbo spin-echo diffusion-weighted imaging

Abstract Background and purpose Turbo spin-echo diffusion-weighted imaging (TSE-DWI) has not been used for evaluating pituitary lesions. We compared the usefulness of TSE-DWI and echo-planar (EP)-DWI for assessing normal pituitary structures and lesions. Materials and methods Our study included 41 consecutive patients (27 pituitary adenomas, 8 Rathke's cleft cysts, 4 craniopharyngiomas, 1 germinoma, 1 pituitary metastasis) who underwent conventional pre- and post-contrast magnetic resonance imaging (MRI) and TSE- and EP-DWI at 3 T. Two observers independently performed qualitative assessment of normal pituitary structures and lesions on sagittal DWI and ADC maps. The ADC of normal brain structures and of pathologically proven pituitary adenomas ( n  = 19) and of craniopharyngiomas ( n  = 3) was recorded. Kappa (κ) statistics, Wilcoxon signed-rank test, Pearson correlation coefficient and independent t -test were used for statistical analysis. Results Interobserver agreement for qualitative evaluations was good to excellent (κ = 0.65–1.0). On both DWI and ADC maps, visualization of the pituitary gland, of the spatial relationship between the lesion and its normal surroundings, and the whole image quality were significantly better on TSE- than EP sequences ( p r  = 0.657, p Conclusions For the evaluation of normal pituitary structures and lesions, TSE-DWI is more useful than EP-DWI. The TSE-ADC value may help to differentiate between pituitary adenoma and craniopharyngioma.