Pituitary

Danial K. Hallam1

1 University of Washington, Seattle, Washington
Publication Name:  Current Protocols in Magnetic Resonance Imaging
Unit Number:  Unit A5.2
DOI:  10.1002/0471142719.mia0502s03
Online Posting Date:  February, 2002
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Abstract

Benefiting from superior tissue contrast, multi‐planar capability and lack of bone artifact, MRI readily depicts complex anatomy in and about the pituitary gland. This unit presents three basic protocols for common indications relating to pathology of the sella and parasellar region. The protocols differ in emphasis more than in concept, and share a basic theme of thin slice high‐resolution imaging including the use of gadolinium. With the possible exception of dynamic imaging, all protocols may be readily performed on any MR scanner.

     
 
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Table of Contents

  • Basic Protocol 1: Macroadenoma
  • Alternate Protocol 1: Status Post Transphenoidal Surgery
  • Basic Protocol 2: Microadenoma
  • Basic Protocol 3: Cavernous Sinus
  • Commentary
  • Figures
  • Tables
     
 
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Materials

Basic Protocol 1: Macroadenoma

  Materials
  • Normal saline (0.9% NaCl), sterile
  • Extravascular contrast agent (e.g., Magnevist, Omniscan, or Prohance)
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Figures

  •   FigureFigure a0.50.1 Displacement of optic apparatus by suprasellar extension of a Rathke's cleft cyst is demonstrated on T1‐weighted coronal image.
  •   FigureFigure a0.50.2 Invasive pituitary adenoma. Involvement of clivus and clear invasion of left cavernous sinus demonstrated by pre‐contrast T1‐weighted coronal image.
  •   FigureFigure a0.50.3 (A) The presence of an ademona is suggested by possible mass effect and hypointensity on non‐contrast T1‐weighted coronal image. (B) Following contrast, adenoma is clearly demarcated by decreased enhancement relative to normal pituitary gland.
  •   FigureFigure a0.50.4 T2‐weighted TSE image can be helpful to better characterize some lesions, as in this case of an arachnoid cyst.
  •   FigureFigure a0.50.5 (A) Non‐contrast T1‐weighted coronal image demonstrates a 2.5 mm microadenoma in the right side of the sella. (B) Following contrast, the lesion is no longer apparent.

Videos

Literature Cited

Literature Cited
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   Macpherson, P., Hadley, D.M., Teasdale, E., and Teasdale, G. 1989. Pituitary microadenomas. Does Gadolinium enhance their demonstration? Neuroradiology 31:293‐298.
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   Shellock, F.G. 1996. Pocket Guide to MR Procedures and Metallic Objects. Lippincott‐Raven, Philadelphia.
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Key References
   Shellock, 1996. See above.
  Covers a number of important patient management issues related to MR imaging, including recommended safety procedures, a list of metallic implants that have been tested for MR compatibility, and a list of other sources on MR safety.
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