Hypopituitarism MRI
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
MRI is the imaging procedure of choice in the diagnosis of hypopituitarism. It is preferred over the CT scan as optic chiasm, pituitary stalk, and cavernous sinuses can be seen in MRI. An MRI lesion needs to be related to clinical and lab findings. The absence of an MRI lesion mostly indicates a non-organic etiology.
MRI
- MRI is the imaging procedure of choice in diagnosis of hypopituitarism. It is preferred over the CT scan as optic chiasm, pituitary stalk, and cavernous sinuses can be seen in MRI.[1]
- MRI is the single best imaging modality in the evaluation of sellar masses as certain findings are suggestive of some specific sellar masses and help to differentiaite them
- A magnetic resonance imaging (MRI) scan may show a three-dimensional image of pituitary gland, hypothalamus, and the organs near them.
- MRI is used to detect the underlying cause of hypopituitarism like the pituitary adenoma that can be seen as a mass with hormonal hypersecretion.
- There is a positive correlation between MRI findings and the number of pituitary hormonal deficiencies.[2][3]
- An MRI lesion needs to be related to clinical and lab findings. The absence of an MRI lesion mostly indicates a non-organic etiology.
- MRI scan shows the following findings in cases of hypopituitarism:[4]
- 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.
- Ectopic posterior lobe of the pituitary gland may be observed in cases of pituitary dwarfism.
- 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
- Meningiomas have a homogenous postcontrast enhancement than pituitary adenomas and have a suprasellar attachment.
Ectopic posterior lobe of the pituitary gland
MRI scan in cases of ectopic posterior lobe shows the following:[5]
- Abscence of the posterior pituitary bright spot
- High T1 signal 3-8-mm tissue nodule at the median eminence (floor of third ventricle)
References
- ↑ Vance, Mary Lee (1994). "Hypopituitarism". New England Journal of Medicine. 330 (23): 1651–1662. doi:10.1056/NEJM199406093302306. ISSN 0028-4793.
- ↑ Li G, Shao P, Sun X, Wang Q, Zhang L (2010). "Magnetic resonance imaging and pituitary function in children with panhypopituitarism". Horm Res Paediatr. 73 (3): 205–9. doi:10.1159/000284363. PMID 20197674.
- ↑ Child CJ, Zimmermann AG, Woodmansee WW, Green DM, Li JJ, Jung H, Erfurth EM, Robison LL (2011). "Assessment of primary cancers in GH-treated adult hypopituitary patients: an analysis from the Hypopituitary Control and Complications Study". Eur. J. Endocrinol. 165 (2): 217–23. doi:10.1530/EJE-11-0286. PMC 3132593. PMID 21646285.
- ↑ 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.
- ↑ Mitchell LA, Thomas PQ, Zacharin MR, Scheffer IE (2002). "Ectopic posterior pituitary lobe and periventricular heterotopia: cerebral malformations with the same underlying mechanism?". AJNR Am J Neuroradiol. 23 (9): 1475–81. PMID 12372734.