MR imaging of the pituitary stalk: size, shape, and enhancement pattern

The size, shape, signal intensity, and enhancement pattern of the normal pituitary stalk were determined retrospectively by review of MR images of 58 patients. The pituitary stalk was measured at the level of the optic chiasm and at its insertion on the pituitary gland. The contour of the stalk was smoothly tapering, measuring 3.25 +/- 0.56 mm in transverse diameter at the optic chiasm and 1.91 +/- 0.40 mm at its pituitary insertion. The signal intensity of the pituitary stalk on unenhanced T1-weighted images was less than that of the neurohypophysis in all cases and less than that of the optic chiasm in 84% of the cases. After the administration of contrast material, enhancement of the pituitary stalk occurred in all cases. A central area of nonenhancement in an otherwise uniformly enhancing stalk was variably present, depending on the size of the infundibular recess. Our study defines the size, contour, and MR signal characteristics of the normal pituitary stalk. These criteria can be used to distinguish the normal from the abnormal stalk.