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Updated: Jan 21, 2026
Multiple-mouse Neuroanatomical Magnetic Resonance Imaging
Published on: February 27, 2011
Prevalence of pituitary cysts in children using modern magnetic resonance imaging techniques
Eman S Mahdi1, Ryan Logan Webb2, Matthew T Whitehead3,4
1Department of Diagnostic Imaging and Radiology, University of Missouri Hospital/Women's and Children's Hospital, One Hospital Drive, Columbia, MO, 65212, USA. mahdie@health.missouri.edu.
Insights
Pituitary cysts are common in children, found in over half of those undergoing brain MRI. These incidental findings rarely cause endocrine issues and usually do not require follow-up.
Area of Science:
- Pediatric Radiology
- Neuroimaging
- Endocrinology
Background:
- Pituitary pars intermedia/Rathke cleft cysts are frequently observed in pediatric brain MRI.
- High-resolution imaging sequences increase detection rates.
Purpose of the Study:
- Determine the prevalence of pituitary cystic lesions in children using modern MRI.
- Assess for associated endocrinopathy.
- Evaluate the need for follow-up.
Main Methods:
- Retrospective review of 232 pediatric brain MRIs (ages 0-18).
- Utilized 1.5- and 3-T scanners with 3-D volumetric T1 SPGR and axial T2-weighted sequences.
- Cyst presence, size, signal characteristics, and volume were assessed; endocrine abnormalities were documented.
Main Results:
- Pituitary cysts were present in 57.7% of children.
- Mean cyst size was 3.6 mm; most were T1 hypointense and T2 isointense.
- Endocrine abnormalities were rare and not linked to pituitary cysts.
Conclusions:
- Modern MRI techniques frequently detect pituitary cysts in children, often incidentally.
- Routine follow-up is generally unnecessary for asymptomatic, non-enlarged pituitary cysts.
Background:
Pituitary pars intermedia/Rathke cleft cysts or cyst-like structures are commonly encountered in children undergoing brain magnetic resonance imaging (MRI), especially when examinations include thin-section, high-resolution sequences.
Objective:
To determine the prevalence of pituitary cystic lesions in children at our institution using modern MRI technique, to assess for associated endocrinopathy and to address the need for follow-up.
Materials And Methods:
We retrospectively reviewed 232 consecutive 1.5- and 3-T brain MRIs in children ages 0-18 years (mean: 8.3±5.3 years). We evaluated 3-D volumetric T1 spoiled gradient echo (SPGR) and axial T2-weighted sequences. Pituitary glands were evaluated for the presence, size and signal characteristics of cysts. Cyst volumes were measured in three orthogonal planes. Endocrine abnormalities were documented from the medical record.
Results:
Pituitary cysts were present in 57.7% of children (n=134), with a mean linear measurement of 3.6±1.17 mm (range: 0.4 to 12.3 mm). The overwhelming majority of cysts were hyopointense on T1-W images (n=121, 90%) and isointense on T2-W images relative to the adenohypophysis (n=106, 79%). T1 hyperintense and T2 hypointense signals were present in a minority, 6.7% and 8%, respectively. Most cysts were occult on post-contrast T1-W images (n=24, 77%). Endocrine abnormalities were present in 2/134 (1.5%) of children with cysts (these were unrelated to the pituitary gland) versus 1/98 (1%) children without cysts (P=0.7).
Conclusion:
More often than not, pituitary cysts/cyst-like structures can be found incidentally in children using modern MRI techniques. Follow-up is not typically required if there are no associated symptoms or excessive size.
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