Article Figures & Data
Figures
- FIG 1.
Sagittal T1WI of the sella (A) demonstrates a gray matter–isointense suprasellar mass lesion (arrow). Sagittal postgadolinium T1WI (B) shows enhancement, indicating a diagnosis of neoplasm (hypothalamic glioma) rather than hamartoma.
- FIG 2.
The black table (upper right, n = 18) indicates discrepant cases between the retrospective noncontrast MR imaging evaluation and the original report that would have required contrast for definitive characterization. Nine of these were diagnosed as microadenoma or suspected microadenoma on original contrast-enhanced MR imaging. The white table (lower right, n = 22) describes discrepant cases with diagnoses that were deemed unlikely to cause the patient's presenting symptoms (probably clinically insignificant discrepancies). PP indicates posterior pituitary.
- FIG 3.
Axial FLAIR (A) and sagittal T2WI (B) show a hyperintense mass lesion (arrows) in the right mesial temporal lobe immediately superior to the hippocampus, most likely representing a low-grade neoplasm. Sagittal T2WI is helpful for localization of this lesion and differentiating it from the choroid plexus in the temporal horn. Although this finding was unrelated to the patient's presentation of GHD, intravenous contrast was needed for complete MR imaging assessment and showed the lesion to be nonenhancing (not shown).
- FIG 4.
Coronal dynamic postgadolinium (A) and delayed (B) T1WIs of the sella show heterogeneous enhancement, with hypoenhancement of the right side of the gland (arrows). This finding was considered equivocal for microadenoma, and the patient underwent multiple follow-up examinations despite the finding being considered clinically unrelated to GHD. The finding led to no clinical intervention.
- FIG 5.
Sagittal mDixon T1WI (A) shows a hyperintense suprasellar mass along the posterior aspect of the infundibulum (long arrow). Sagittal mDixon T1-weighted water-only image (B) shows complete suppression of this mass, which is diagnostic of lipoma. The neurohypophysis is bright on the water-only images and is highlighted against suppressed fat in the dorsum sellae (short arrow, B). mDixon T1WI is helpful for evaluation of fat-containing sellar region lesions and identification of the normal orthotopic neurohypophysis. Furthermore, it can differentiate a fat-containing lesion from ectopic neurohypophysis.
- FIG 6.
Sagittal T2WI shows a hypointense pars intermedia cyst (arrow) that was not definitely visible on sagittal T1WI (not shown). This case highlights this sequence being complementary to T1WI and helpful for identification and characterization of sellar cystic lesions. It is suggested as part of the rapid noncontrast pituitary protocol because it further decreases the needed for intravenous contrast.
Tables
Clinical Variable Total (n = 442) Normal (n = 308) Abnormal (n = 134) P Valuea Age (yr) 8.2 8.5 7.5 .003 Sex (No.) (%) .49 Male 233 (53) 159 (52) 74 (55) Female 209 (47) 149 (48) 60 (45) Clinical indication (No.) (%) .44 GHD 216 (49) 145 (47) 71 (53) CPP 154 (35) 113 (37) 41 (31) SS 72 (16) 50 (16) 22 (16) Sedation (No.) (%) 225 (51) 147 (48) 78 (58) .04 Duration of study (hr:min:sec) 0:56:19 0:56:57 0:54:52 .20 ↵a The P value for quantitative variables was calculated using a t test of unequal variance. The P value for categoric variables was calculated using a χ2 test.
- Table 2:
Most common radiologic findings in 134 MR imaging studies with abnormal hypothalamic-pituitary region findings obtained for evaluation of GHD, CPP, or SS
MR Imaging Findings Studies (No.) (%) Pars intermedia or Rathke cleft cyst 38 (28) Subjectively small anterior pituitary 36 (27) Ectopic or absent posterior pituitary 20 (15) Empty sella 15 (11) Postpubertal pituitary 14 (10) Pituitary stalk interruption 12 (9) Possible microadenoma 9 (7) Suprasellar mass or cystic lesion 6 (4) - Table 3:
Additional findings in pituitary MR imaging studies obtained for evaluation of GHD, CPP, or SS
Additional MR Imaging Finding (n = 146, 33%) Studies (No.) (%) Nonspecific T2 or FLAIR hyperintensities 45 (10) Sinus disease 39 (9) Chiari I malformation or cerebellar tonsillar ectopia 18 (4) Intracranial cysts 18 (4) Pineal cyst 7 Posterior fossa/temporal lobe arachnoid cyst 6 Choroid fissure cyst 2 Congenital anomaly 14 (3) Dysmorphic skull base 5 Corpus callosum abnormality 5 Vascular anomaly 7 (2) Cavernous malformation 2 Cerebral aneurysm 1 Suspected mass 6 (1) Presumed low-grade glioma or neoplasm 5 Dysembryoblastic neuroepithelial tumor 1 Migrational abnormality 6 (1)
