The various MRI patterns of pituitary apoplexy |
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Authors: | M Piotin D Tampieri D A Rüfenacht G Mohr M Garant R Del Carpio F Robert J Delavelle D Melanson |
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Affiliation: | (1) Department of Radiology, Montreal Neurological Hospital and Institute, H3A 2B4 Montreal, Canada, CA;(2) Department of Diagnostic and Interventional Radiology, Geneva University Hospital, CH-1211 Geneva 14, Switzerland, CH;(3) Department of Neurosurgery, Sir Mortimer B. Davis Jewish General Hospital, H3T 1E2 Montreal, Canada, CA;(4) Department of Radiology, Montreal General Hospital, H3G 1A4 Montreal, Canada, CA;(5) Department of Pathology, Sir Mortimer B. Davis Jewish General Hospital, H3T 1E2 Montreal, Canada, CA |
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Abstract: | The aim of this study was to describe the various MRI features, in correlation to surgical and pathological findings, in
patients who presented with pituitary apoplexy (PA). Eleven patients presenting with PA, were evaluated with various MR protocols
including spin-echo (SE) T1-weighted sequences in 9 of 11 patients, post gadolinium SE T1-weighted sequences in only 8 of
11 patients, and with T2-weighted SE sequences in 2 of 11 patients. All patients had transsphenoidal pituitary surgery after
MR studies. The severity of presenting symptoms ranged from headaches to coma. Ten patients had pituitary macroadenoma; one
had a non-hemorrhagic metastatic lesion into a non-adenomatous pituitary gland. Of the 11 patients, one was studied at the
acute stage of PA (1 day after onset), 9 at the subacute period (3–15 days after onset), and one at the late stage (5 months
after onset). Images compatible with intratumoral hemorrhage were found in all macroadenomas, whereas the metastatic pituitary
lesion did not show evidence of bleeding. All gadolinium-enhanced studies showed partial tumoral enhancement. The SE T2-weighted
studies demonstrated areas of low and high signal intensities in keeping with the presence of blood degradation contents.
Pituitary apoplexy present with different MR features, including hemorrhagic and non-hemorrhagic characteristics on T1-weighted
images. Gadolinium-enhanced images do not provide complementary diagnostic information when the presence of blood is assessed
on plain images.
Received: 20 May 1998; Revision received: 11 September 1998; Accepted: 14 September 1998 |
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Keywords: | : Pituitary apoplexy Pituitary hemorrhage Pituitary tumors MR imaging |
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