Normal pituitary gland: coronal MR imaging of infundibular tilt

To determine the prevalence of pituitary infundibular deviation or tilt as a normal variant, coronal magnetic resonance (MR) images of 50 patients who had been examined for reasons other than pituitary disease were evaluated retrospectively. Forty-six percent of the patients had a more or less pronounced tilt of the pituitary stalk. This tilt was due to developmental lateral eccentricity of the pituitary gland in relationship to the midline of the brain in 34% and to ontogenic eccentric insertion of the pituitary infundibulum off the midline of the gland in the other 12%. This high frequency of stalk deviation in patients without pituitary disease suggests that such displacement by itself should not be used to support the presence of pituitary microadenoma on MR images or computed tomograms.