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Published on: January 17, 2018
Assessment of hemorrhage in pituitary macroadenoma by T2*-weighted gradient-echo MR imaging
1Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan. nstosaka@med.gunma-u.ac.jp
Background And Purpose:
Intratumoral hemorrhage occurs frequently in pituitary macroadenoma and manifests as pituitary apoplexy and recent or old silent hemorrhage. T2*-weighted gradient-echo (GE) MR imaging is the most sensitive sequence for the detection of acute and old intracranial hemorrhage. T2*-weighted GE MR imaging was used to investigate intratumoral hemorrhage in pituitary macroadenomas.
Materials And Methods:
Twenty-five consecutive patients who underwent total or subtotal resection of pituitary macroadenoma with heights from 17 to 53 mm, including 1 patient with classic pituitary apoplexy, underwent MR imaging before surgery, including T2*-weighted GE MR imaging. For histologic assessment of the hemorrhage in whole surgical specimens, we used hematoxylin-eosin staining.
Results:
T2*-weighted GE MR imaging detected various types of dark lesions, such as "rim," "mass," "spot," and "diffuse" and combinations, indicating clinical and subclinical intratumoral hemorrhage in 12 of the 25 patients. The presence of intratumoral dark lesions on T2*-weighted GE MR imaging correlated significantly with the hemorrhagic findings on T1- and T2-weighted MR imaging (P < .02 and <.01, respectively), and the surgical and histologic hemorrhagic findings (P < .001 and <.001, respectively).
Conclusion:
T2*-weighted GE MR imaging could detect intratumoral hemorrhage in pituitary adenomas as various dark appearances. Therefore, this technique might be useful for the assessment of recent and old intratumoral hemorrhagic events in patients with pituitary macroadenomas.
Insights
T2*-weighted GE MR imaging effectively detects intratumoral hemorrhage in pituitary macroadenomas, including silent bleeding. This sensitive MRI technique aids in assessing both recent and old hemorrhagic events in patients.
Area of Science:
- Radiology
- Neuroimaging
- Endocrinology
Background:
- Intratumoral hemorrhage is common in pituitary macroadenomas, presenting as pituitary apoplexy or silent hemorrhage.
- T2*-weighted gradient-echo (GE) MR imaging is highly sensitive for detecting intracranial hemorrhage.
Purpose of the Study:
- To investigate the utility of T2*-weighted GE MR imaging in detecting intratumoral hemorrhage in pituitary macroadenomas.
Main Methods:
- Twenty-five patients with pituitary macroadenomas underwent pre-operative MR imaging, including T2*-weighted GE sequences.
- Histologic assessment using hematoxylin-eosin staining was performed on surgical specimens.
Main Results:
- T2*-weighted GE MR imaging identified various dark lesions indicative of hemorrhage in 12 of 25 patients.
- The presence of these dark lesions correlated significantly with findings from T1/T2-weighted MR imaging and surgical/histologic assessments.
Conclusions:
- T2*-weighted GE MR imaging is a valuable tool for detecting intratumoral hemorrhage in pituitary adenomas.
- This technique can help assess both recent and old hemorrhagic events in patients with pituitary macroadenomas.
