Hypopituitarism MRI: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Hypopituitarism}}
{{Hypopituitarism}}
{{CMG}}; {{AE}} {{AEL}}
{{CMG}}; {{AE}} {{AEL}} {{IQ}}


==Overview==
==Overview==

Revision as of 13:14, 13 September 2017

Hypopituitarism Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypopituitarism from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hypopituitarism MRI On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hypopituitarism MRI

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hypopituitarism MRI

CDC on Hypopituitarism MRI

Hypopituitarism MRI in the news

Blogs on Hypopituitarism MRI

Directions to Hospitals Treating Hypopituitarism

Risk calculators and risk factors for Hypopituitarism MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2] Iqra Qamar M.D.[3]

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. Cystic lesions, such as Rathke's cleft cysts may have a low-intensity signal on T1-weighted images and a high-intensity signal on T2-weighted images. Meningiomas have a homogenous postcontrast enhancement than pituitary adenomas and have a suprasellar attachment. Hemorrhage into the pituitary gland results in a high-intensity signal on both T1- and T2-weighted images.

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.[5]
  • Hemorrhage into the pituitary gland results in a high-intensity signal on both T1- and T2-weighted images.

Ectopic posterior lobe of the pituitary gland

MRI scan in cases of ectopic posterior lobe shows the following:[6]

  • Abscence of the posterior pituitary bright spot
  • High T1 signal 3-8-mm tissue nodule at the median eminence (floor of third ventricle)

References

  1. Vance, Mary Lee (1994). "Hypopituitarism". New England Journal of Medicine. 330 (23): 1651–1662. doi:10.1056/NEJM199406093302306. ISSN 0028-4793.
  2. 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.
  3. 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.
  4. 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.
  5. Taylor SL, Barakos JA, Harsh GR, Wilson CB (1992). "Magnetic resonance imaging of tuberculum sellae meningiomas: preventing preoperative misdiagnosis as pituitary macroadenoma". Neurosurgery. 31 (4): 621–7, discussion 627. PMID 1407446.
  6. 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.


Template:WH Template:WS