Ectopic posterior pituitary high signal in preoperative and postoperative macroadenomas: dynamic MR imaging

Takahashi, Takahiro; Miki, Yukio; Takahashi, J.; Kanagaki, Mitsunori; Yamamoto, Akira; Fushimi, Yasutaka; Okada, Tsutomu; Haque, Tabassum Laz; Hashimoto, Nobuo; Konishi, Junji; Togashi, Kaori

doi:10.1016/j.ejrad.2004.10.003

Cited by 9 publications

(8 citation statements)

References 17 publications

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“…However, some studies revealed that even if the compression on the pituitary stalk was relieved after the resection of a pituitary macroadenoma, the position of EPPHS relative to the pituitary stalk did not change, and the hyperintense signal of the normal posterior pituitary did not reappear. The EPPHS can also show enhancement characteristics similar to a normal posterior pituitary, suggesting that it has a good blood supply (14). These results suggest that the formation of EPPHS in pituitary macroadenoma is accompanied by complex pathophysiological changes.…”

Section: Discussionmentioning

confidence: 65%

Diagnostic value of magnetic resonance imaging ectopic posterior pituitary hyperintense signal in pituitary macroadenoma

Luo

Fan

et al. 2022

Front. Oncol.

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ObjectiveWhen the lesions in the sellar region are large, they can involve both the inside and outside the sella, which brings challenges to the differential diagnosis of pituitary macroadenoma and lesions other than macroadenoma. Therefore, this study explored the diagnostic value of an ectopic posterior pituitary hyperintense signal (EPPHS) in pituitary macroadenoma and its possible causes.MethodsThe clinical and imaging data of 131 patients with sellar tumors or tumor-like lesions involving both intrasellar and extrasellar regions in the Affiliated Hospital of Guizhou Medical University from February 2011 to December 2021 were analyzed retrospectively. The diagnostic value of EPPHS in pituitary macroadenoma was analyzed. The differences in clinical and imaging indexes between the EPPHS-positive group and the EPPHS-negative group were compared.ResultsThese 131 cases of sellar tumors or tumor-like lesions involving both intrasellar and extrasellar regions included 91 cases of pituitary macroadenoma and 40 cases of lesions other than macroadenoma. The receiver operator characteristic (ROC) curve analysis suggested that EPPHS had a diagnostic value in diagnosing pituitary macroadenoma [area under the curve (AUC) = 0.857, P = 0.0001]. Compared with the EPPHS negative group, the median prolactin level in the EPPHS positive group was significantly higher (P < 0.05). Through ROC curve analysis, prolactin value was found to be of diagnostic value for EPPHS (AUC = 0.612, P = 0.0312).ConclusionIn sellar tumors or tumor-like lesions involving both intrasellar and extrasellar regions, the appearance of EPPHS is helpful in the diagnosis of pituitary macroadenoma. The formation of EPPHS may be related to injuries to the pituitary stalk.

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Section: Discussionmentioning

confidence: 65%

Diagnostic value of magnetic resonance imaging ectopic posterior pituitary hyperintense signal in pituitary macroadenoma

Luo

Fan

et al. 2022

Front. Oncol.

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“…Second, the ROI of air in the sphenoid sinus just below the pituitary lobe was adopted for normalization. ROI of the pons has been adopted for comparison in previous studies because of signal intensity invariance 7,28 , but both 3D and 2D dynamic images failed to cover the pons. Furthermore, tissue adjacent to the pituitary should be referred to in the context of parallel imaging due to the complicated sampling reduction, with a net reduction factor of 4, applied in the CAIPIRINHA method in this study.…”

Section: Discussionmentioning

confidence: 99%

“…The normal pituitary typically enhances within the first 1-2 min after contrast injection and shows an enhancement pattern consistent with the vascular architecture of the pituitary, with the posterior lobe enhancing earlier than the anterior lobe. Dynamic MR imaging has provided beneficial information for various situations by demarcating normal pituitary gland: microadenomas 1,4 , Cushing disease 5,6 , ectopic pituitary gland 7 , idiopathic growth hormone deficiency 8 , Tolosa-Hunt syndrome 9 , and adjacent tissues 10 . Asymmetrical pituitary enhancement on dynamic MR imaging is also observed due to localized venous congestion caused by cavernous sinus arteriovenous fistula 11 .…”

Section: Text Introductionmentioning

confidence: 99%

3D dynamic pituitary MR imaging with CAIPIRINHA: Initial experience and comparison with 2D dynamic MR imaging

Fushimi

Okada

Kanagaki

et al. 2014

European Journal of Radiology

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“…T2-weighted unenhanced images are also performed sometimes, but most authors have reported postoperative studies of the sellar region using only T1-weighted images [18–20]. There are only a few papers concerning applications of T2-weighted sequences in imaging of the postoperative sella [21–23].…”

Section: Introductionmentioning

confidence: 99%

Are T2-weighted images more useful than T1-weighted contrast-enhanced images in assessment of postoperative sella and parasellar region?

et al. 2011

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SummaryBackgroundThe proper diagnosis and management of patients after surgery for pituitary tumors are of great importance in clinical practice. The purpose of this study was to investigate the magnetic resonance features of the postoperative sella with fast spin echo T2-weighted imaging and to evaluate the benefits of this sequence compared to the classically performed contrast-enhanced T1-weighted imaging at 1.5T unit.Material/MethodsThe study group consisted of 101 patients who underwent resection of pituitary tumors. There were 58 women (57.4%), aged 22 to 75 (mean age, 52.67 years) and 43 men (42.6%), aged 21 to 79 (mean age, 49 years). In all patients preoperative and multiple postoperative MR studies were performed. Post-contrast T1 and pre-contrast T2 images were interpreted by 2 independent readers (neuroradiologists).ResultsContrast-enhanced T1-weighted imaging was significantly superior to T2-weighted imaging in assessment of infundibulum (p<0.05). There was no statistically significant difference for each of readers between T1- and T2-weighted images regarding to the following features: visualization of residual pituitary gland (p=0.062 and p=0.368), contours of pituitary (p=0.959 and p=0.265), optic chiasm (p=0.294 and p=0.843), and visualization of presence of residual tumor (p=0.204 and p=0.169). T2-weighted images were significantly superior to contrast-enhanced T1-weighted imaging with regard to visualization of contours of residual tumors (p<0.05).ConclusionsT2-weighted images may help to discriminate tumorous from non-tumorous involvement of the postoperative sella and the sphenoid sinus. T2-weighted images are also very useful for a long time after the resection in the postoperative evaluation of the implanted muscle with fascia.

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Ectopic posterior pituitary high signal in preoperative and postoperative macroadenomas: dynamic MR imaging

Cited by 9 publications

References 17 publications

Diagnostic value of magnetic resonance imaging ectopic posterior pituitary hyperintense signal in pituitary macroadenoma

Diagnostic value of magnetic resonance imaging ectopic posterior pituitary hyperintense signal in pituitary macroadenoma

3D dynamic pituitary MR imaging with CAIPIRINHA: Initial experience and comparison with 2D dynamic MR imaging

Are T2-weighted images more useful than T1-weighted contrast-enhanced images in assessment of postoperative sella and parasellar region?

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