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Distortion of Normal Pituitary Structures in Sellar Pathologies on MRI

Published online by Cambridge University Press:  02 December 2014

Burak Sade ,
Gérard Mohr  and
Jean Lorrain Vézina
Burak Sade
Affiliation:
Division of Neurosurgery, McGill University, Montreal, Quebec Canada
Gérard Mohr
Affiliation:
Division of Neurosurgery, McGill University, Montreal, Quebec Canada
Jean Lorrain Vézina
Affiliation:
Sir Mortimer B. Davis-Jewish General Hospital, McGill University and Department of Radiology, McGill University, Montreal, Quebec Canada
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Abstract

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Objective:

This study was undertaken to assess the displacement patterns and shifts of the normal pituitary gland in sellar pathologies on MRI and to determine if the position of the bright spot (BS) represents a predicting factor for the position of the residual adenohypophysis (RAH) in pathological conditions.

Methods:

In a control group of 102 patients without any pituitary pathology, the presence of the BS was evaluated. In 100 patients with intra- or suprasellar pathologies, presence and respective topography of BS and RAH were scrutinized on MRI, according to lesion type, size, endocrine status and intra-operative findings in the surgical group.

Results:

The BS was visible in 91.2% of 102 cases in the control group, as compared to 75 of the 100 patients with sellar lesions. Location of RAH was identified in 58% of the patients, and RAH enhanced more than the lesion in all cases after contrast infusion. The RAH was identified in 65.3% of the 75 “BS positive” patients, as compared to 36% of the 25 “BS negative”. The normal residual gland was visualized intra-operatively in 63.5% of the 52 operated patients: in 37 “BS positive” patients, it was visualized intra-operatively in 81.1% and in 28 “RAH positive” patients, it was identified in 82.1%.

Conclusion:

The BS can be identified in the majority and RAH in more than half of the cases with pituitary lesions on MRI. Positions of both the BS and RAH help predict the location of the normal residual gland during surgery and, therefore, may contribute to preserving the pituitary function.

Type
Other
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 4 , November 2004 , pp. 467 - 473
Copyright
Copyright © The Canadian Journal of Neurological 2004

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