RT Journal Article
SR Electronic
T1 Abnormal Perfusion of the Pituitary Gland Secondary to Dural Arteriovenous Fistulas in the Cavernous Sinus: Dynamic MR Findings
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 930
OP 936
VO 24
IS 5
A1 Shigematsu, Yoshinori
A1 Korogi, Yukunori
A1 Kitajima, Mika
A1 Ishii, Akihiko
A1 Liang, Luxia
A1 Yamura, Masayuki
A1 Kawanaka, Kouich
A1 Takahashi, Mutsumasa
YR 2003
UL http://www.ajnr.org/content/24/5/930.abstract
AB BACKGROUND AND PURPOSE: If venous congestion is the primary cause of pituitary gland enlargement in cases of dural arteriovenous fistulas (AVFs), other abnormal pituitary findings may be detectable on MR images. We sought to investigate the perfusion abnormality of the pituitary gland secondary to dural AVFs in the cavernous sinus and to clarify its clinical importance.METHODS: Nine consecutive patients (all female; age range, 50–77 years) with dural AVFs in the cavernous sinus underwent prospective MR examinations, including dynamic studies, before and after therapy. Their clinical signs and symptoms were recorded. Two radiologists visually evaluated the enhancement patterns of the anterior pituitary gland. Dynamic MR curves were obtained by locating regions of interest at the center and bilateral peripheral areas of the anterior pituitary gland on coronal images. MR images obtained in five healthy individuals served as controls.RESULTS: No patient had symptoms of hypopituitarism or other endocrine abnormalities. Asymmetric pituitary enhancement was found in five patients; the side with the dural AVF was less enhancing. This finding disappeared after therapy. Although asymmetric enhancement was not detected in the remaining four patients, statistical analysis showed significantly delayed enhancement of the pituitary gland in the patients compared with enhancement patterns in control subjects. After treatment, this delay improved significantly. The pituitary gland significantly decreased in size after treatment.CONCLUSION: Perfusion of the pituitary gland is impaired in patients with a dural AVF in the cavernous sinus. This finding is probably due to venous congestion of the pituitary gland caused by high pressure in the cavernous sinus; it is usually not related to pituitary dysfunction.