Assessment of Hemorrhage in Pituitary Macroadenoma by T2*-Weighted Gradient-Echo MR Imaging

Tosaka, Masahiko; Sato, Noriko; Hirato, Junko; Fujimaki, Hiroya; Yamaguchi, Raizou; Kohga, Hideaki; Hashimoto, Kazuhito; Yamada, Masanobu; Mori, Masatomo; Saito, Naoya; Yoshimoto, Yuhei

doi:10.3174/ajnr.a0692

Cited by 68 publications

(39 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the MR images, acute and subacute hemorrhage characteristically exhibited T1 hyperintensity on pre-contrast imaging with minimal or no enhancement on post-contrast imaging, consistent with previous descriptions of intratumoral hemorrhage [21][22]. The tumor was distinguished from normal pituitary by virtue of its morphology and hypoenhancement on post-contrast T1-weighted images.…”

Section: Software-calculated Volumetric Measurementsupporting

confidence: 66%

Endoscopic Endonasal Transsphenoidal Treatment of Pituitary Apoplexy: Outcomes in a Series of 20 Patients

Yang¹,

Anand²,

Schwartz³

2013

J Neurol Surg B

View full text Add to dashboard Cite

Section: Software-calculated Volumetric Measurementsupporting

confidence: 66%

Endoscopic Endonasal Transsphenoidal Treatment of Pituitary Apoplexy: Outcomes in a Series of 20 Patients

Yang¹,

Anand²,

Schwartz³

2013

J Neurol Surg B

View full text Add to dashboard Cite

“…Previously, T2*-weighted imaging was proposed as a potential way to detect intratumoral hemorrhage in pituitary adenomas. 7 Another study in which diffusion-weighted MR imaging was used revealed that the ADC values of RCCs were significantly higher than those of other cystic lesions, including cystic or hemorrhagic pituitary adenomas; therefore, diffusion-weighted MR imaging may be useful for differentiating cystic lesions in the pituitary fossa. 36 However, these sequences are not routinely performed for standard sellar MR imaging because of susceptibility artifacts related to the skull base and, thus, were not performed in our patients.…”

Section: Discussionmentioning

confidence: 99%

“…Intratumoral hemorrhage in pituitary adenomas is common even without clinical symptoms. 7,31,32 Thus, clinical symptoms themselves are not always sufficient to make a correct diagnosis of hemorrhagic adenoma. Furthermore, hemorrhagic pituitary adenomas can exhibit various signal intensities on both T1-and T2-weighted MR imaging, which makes imaging diagnoses difficult.…”

Section: Discussionmentioning

confidence: 99%

“…3 Intratumoral hemorrhage and ischemic infarction are common with larger pituitary adenomas, which may result in hemorrhagic or cystic changes or both, leading to various signal intensities on MR imaging. [4][5][6][7][8] Rathke cleft cyst (RCC) is a benign epithelial cyst believed to originate from the remnants of the Rathke pouch. 9 Typical imaging findings include a nonenhancing, noncalcified, intrasellar/ suprasellar cyst with an intracystic nodule.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Differentiation between Cystic Pituitary Adenomas and Rathke Cleft Cysts: A Diagnostic Model Using MRI

Park

Lee

Choi³

et al. 2015

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE:Cystic pituitary adenomas may mimic Rathke cleft cysts when there is no solid enhancing component found on MR imaging, and preoperative differentiation may enable a more appropriate selection of treatment strategies. We investigated the diagnostic potential of MR imaging features to differentiate cystic pituitary adenomas from Rathke cleft cysts and to develop a diagnostic model.

show abstract

“…Sella MRI has been reported the choice of neuroimaging method and diffusion weighted MRI may assist in early A B D C detection of acute pituitary tumor infarction 10,14) . Our cases showed that pituitary apoplexy caused by pituitary adenoma infarction must be suspected in patients who have clinical symptoms and signs or peripheral rim enhancement without hemorrhage on sella MRI.…”

mentioning

confidence: 99%

Pituitary Apoplexy due to Pituitary Adenoma Infarction

Kim

Park

Kim

et al. 2008

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Pituitary apoplexy is a life-threatening clinical syndrome which is caused by the fulminant expansion of pituitary mass due to hemorrhage, hemorrhagic infarction or infarction of pituitary adenoma or the adjacent tissues of pituitary gland. Since first introduced by Bailey in 1898, the incidence of pituitary apoplexy varies from 0.6% to 22.8% 7,11,12,17) . However, pituitary apoplexy due to tumor infarction is very rare. We report two cases of pituitary apoplexies, caused by pituitary tumor infarction after surgery by transsphenoidal approach (TSA) for pituitary macroadenomas. These cases showed pathologic findings of tumor infarction without any signs of related hemorrhage or hemorrhagic infarction. CASE REPORT Case 1A 44-year-old male patient was admitted via emergency room due to sudden onset of severe headache, nausea, vomiting and visual disturbance. These symptoms were developed 5 days prior to admission. He had no specific previous medical history. Subarachnoid hemorrhage (SAH) was ruled out on brain computed tomography (CT), however sella magnetic resonance imaging (MRI) showed a mass lesion in the sella and suprasellar area which was measured about 3.1×2.3×2.2 cm. On T1 weighted images, there was hyperintense peripheral portion and an isointense central portion. With gadolinium (Gd) enhancement, the mass showed peripheral rim enhancement but there was no enhancement in the hypointense central portion (Fig. 1). Diffusion MR images were not obtained due to emergency operation. The optic chiasm was compressed by the mass which resulted in bitemporal hemianopsia and the worsening of the visual acuity of the right eye to 0.4 and maintaining that of the left, 1.1. There was a decrease in the levels of free T4 (4 µg/dl), TSH (0.28 µU) and cortisol (2 µg/dl). Steroid was administered before the operation. The mass was totally resected by TSA and there was no evidence of remaining enhancing tumor or hemorrhage seen in the postoperative first day follow-up sella MRI (Fig. 2). Microscopic examination of the resected mass showed total infarction without viable tumor cells (Fig. 2). The cells showed pale appearance and maintained cellular architecture. These findings led to the diagnosis of pituitary apoplexy due to total tumor infarction of a nonfunctioning pituitary macroadenoma. Clinical symptoms and

show abstract

Assessment of Hemorrhage in Pituitary Macroadenoma by T2*-Weighted Gradient-Echo MR Imaging

Cited by 68 publications

References 34 publications

Endoscopic Endonasal Transsphenoidal Treatment of Pituitary Apoplexy: Outcomes in a Series of 20 Patients

Endoscopic Endonasal Transsphenoidal Treatment of Pituitary Apoplexy: Outcomes in a Series of 20 Patients

Differentiation between Cystic Pituitary Adenomas and Rathke Cleft Cysts: A Diagnostic Model Using MRI

Pituitary Apoplexy due to Pituitary Adenoma Infarction

Contact Info

Product

Resources

About