Secondary adrenal insufficiency MRI: Difference between revisions
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{{ | {{Secondary adrenal insufficiency}} | ||
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==Overview== | ==Overview== | ||
MRI is the diagnostic imaging modality used in secondary adrenal insufficiency to assess [[hypothalamic pituitary adrenal axis]]. MRI findings suggestive of pituitary abnormality may include a mass suggesting a tumor or empty sella leading to [[hypopituitarism]]. | |||
==MRI== | ==MRI== | ||
*[[Magnetic resonance imaging|MRI]] <nowiki/>scan may show the following findings in cases of adrenal insufficiency due to [[hypopituitarism]]:<ref name="Pozzi MucelliFrezza1992">{{cite journal|last1=Pozzi Mucelli|first1=R. S.|last2=Frezza|first2=F.|last3=Magnaldi|first3=S.|last4=Proto|first4=G.|title=Magnetic resonance imaging in patients with panhypopituitarism|journal=European Radiology|volume=2|issue=1|year=1992|pages=42–46|issn=0938-7994|doi=10.1007/BF00714180}}</ref> | |||
**Decreased size of the [[pituitary gland]] | |||
**[[Empty sella]] may be noticed in some cases | |||
**[[Pituitary stalk]] may be visible, thin, or totally absent | |||
**[[Posterior lobe]] of the [[pituitary]] may be absent | |||
**Mass may appear in the [[pituitary]] | |||
**Pituitary adenomas with a diameter >1cm are thought to be associated with secondary adrenal insufficiency when compared to microadenomas | |||
**[[Ectopic]] [[posterior lobe]] of the [[pituitary gland]] may be observed in cases of [[Pituitary dwarfism II|pituitary dwarfism]] | |||
**Infiltrative disorders such a [[sarcoidosis]] and [[histiocytosis]] may present as thickening of infundibulum<ref name="pmid22015494">{{cite journal |vauthors=Imashuku S, Kudo N, Kaneda S, Kuroda H, Shiwa T, Hiraiwa T, Inagaki A, Morimoto A |title=Treatment of patients with hypothalamic-pituitary lesions as adult-onset Langerhans cell histiocytosis |journal=Int. J. Hematol. |volume=94 |issue=6 |pages=556–60 |year=2011 |pmid=22015494 |doi=10.1007/s12185-011-0955-z |url=}}</ref> | |||
**In [[central DI]], T1 weighted MR shows absence of high internsity bright spot that is normally seen in [[Posterior pituitary gland|posterior pituitary]]<ref name="pmid7625990">{{cite journal |vauthors=De Herder WW, Lamberts SW |title=Imaging of pituitary tumours |journal=Baillieres Clin. Endocrinol. Metab. |volume=9 |issue=2 |pages=367–89 |year=1995 |pmid=7625990 |doi= |url=}}</ref> | |||
* Cystic lesions, such as [[Rathke's pouch|Rathke's cleft]] cysts may have | |||
** A low-intensity signal on T1-weighted images | |||
** A high-intensity signal on T2-weighted images | |||
{| | |||
: | |[[ File:Empty sella gif.gif |thumb|500px|Empty Sella. Source: Wikimedia Commons<ref name="urlFile:Empty Sella MRT FLAIR sag 001.jpg - Wikimedia Commons">{{cite web |url=https://commons.wikimedia.org/wiki/File:Empty_Sella_MRT_FLAIR_sag_001.jpg |Hellerhoff |title=File:Empty Sella MRT FLAIR sag 001.jpg - Wikimedia Commons |format= |work= |accessdate=}}</ref>]] | ||
: | | | ||
: | [[File:Pituitary-macroadenoma-necrotic-1marked reduced.jpg|thump|50px|MRI showing necrotic pituitary adenoma (Source: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 17664)|frame]] | ||
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|} | |||
==References== | ==References== | ||
{{ | {{reflist|2}} | ||
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Latest revision as of 14:20, 16 November 2017
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Secondary adrenal insufficiency Microchapters |
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Secondary adrenal insufficiency MRI On the Web |
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Risk calculators and risk factors for Secondary adrenal insufficiency MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]
Overview
MRI is the diagnostic imaging modality used in secondary adrenal insufficiency to assess hypothalamic pituitary adrenal axis. MRI findings suggestive of pituitary abnormality may include a mass suggesting a tumor or empty sella leading to hypopituitarism.
MRI
- MRI scan may show the following findings in cases of adrenal insufficiency due to hypopituitarism:[1]
- Decreased size of the pituitary gland
- Empty sella may be noticed in some cases
- Pituitary stalk may be visible, thin, or totally absent
- Posterior lobe of the pituitary may be absent
- Mass may appear in the pituitary
- Pituitary adenomas with a diameter >1cm are thought to be associated with secondary adrenal insufficiency when compared to microadenomas
- Ectopic posterior lobe of the pituitary gland may be observed in cases of pituitary dwarfism
- Infiltrative disorders such a sarcoidosis and histiocytosis may present as thickening of infundibulum[2]
- In central DI, T1 weighted MR shows absence of high internsity bright spot that is normally seen in posterior pituitary[3]
- Cystic lesions, such as Rathke's cleft cysts may have
- A low-intensity signal on T1-weighted images
- A high-intensity signal on T2-weighted images
 |
 |
References
- ↑ Pozzi Mucelli, R. S.; Frezza, F.; Magnaldi, S.; Proto, G. (1992). "Magnetic resonance imaging in patients with panhypopituitarism". European Radiology. 2 (1): 42–46. doi:10.1007/BF00714180. ISSN 0938-7994.
- ↑ Imashuku S, Kudo N, Kaneda S, Kuroda H, Shiwa T, Hiraiwa T, Inagaki A, Morimoto A (2011). "Treatment of patients with hypothalamic-pituitary lesions as adult-onset Langerhans cell histiocytosis". Int. J. Hematol. 94 (6): 556–60. doi:10.1007/s12185-011-0955-z. PMID 22015494.
- ↑ De Herder WW, Lamberts SW (1995). "Imaging of pituitary tumours". Baillieres Clin. Endocrinol. Metab. 9 (2): 367–89. PMID 7625990.
- ↑ "File:Empty Sella MRT FLAIR sag 001.jpg - Wikimedia Commons". Text "Hellerhoff " ignored (help)
