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Published on: May 20, 2016
Pituitary microadenoma. MR appearance and correlation with CT
1China-Japan Friendship Hospital, Beijing, P.R. China.
Abstract:
Twenty surgically proven pituitary microadenomas were examined with MR imaging and CT. MR demonstrated 20 of 20 microadenomas: 90% of the tumors were hypointense on T1-weighted images before Gd-DTPA administration and in 45% the tumors were more clearly delineated postcontrast. CT demonstrated 19 of 20 diagnosed microadenomas: showing low attenuation in 85% of the tumors precontrast. Iohexol facilitated delineation of the tumors in 45%. Focal enlargement of the gland and diaphragma sellae convexity were more useful than infundibular tilting and sellar-floor erosion as ancillary findings supporting the diagnosis. In general, CT and MR agreed regarding the microadenomas size and location, measurement of enlarged intrasellar contents, detection of the diaphragma sellae bulge, and demonstration of infundibulum abnormality. CT was more sensitive than MR in identifying sellar-floor erosion. We suggest that CT be the first method for demonstration of microadenomas.
Insights
Computed tomography (CT) and magnetic resonance (MR) imaging both detect pituitary microadenomas. CT showed higher sensitivity in identifying sellar-floor erosion, making it a suggested first-line diagnostic method.
Area of Science:
- Radiology
- Endocrinology
- Neurosurgery
Background:
- Pituitary microadenomas are small tumors of the pituitary gland.
- Accurate imaging is crucial for diagnosis and surgical planning.
Purpose of the Study:
- To compare the efficacy of MR imaging and CT in detecting surgically proven pituitary microadenomas.
- To evaluate ancillary imaging findings that support the diagnosis of microadenomas.
Main Methods:
- Twenty surgically confirmed pituitary microadenomas were retrospectively analyzed using MR imaging and CT.
- Tumor characteristics, including signal intensity (MR) and attenuation (CT), were assessed before and after contrast administration (Gd-DTPA for MR, Iohexol for CT).
- Ancillary findings such as gland enlargement, diaphragma sellae convexity, infundibular tilting, and sellar-floor erosion were evaluated.
Main Results:
- MR imaging detected all 20 microadenomas, with 90% appearing hypointense on precontrast T1-weighted images.
- CT detected 19 of 20 microadenomas, with 85% showing low attenuation precontrast.
- CT demonstrated greater sensitivity than MR in identifying sellar-floor erosion; both modalities showed agreement on size, location, and other findings.
Conclusions:
- Both MR imaging and CT are effective in diagnosing pituitary microadenomas.
- Focal gland enlargement and diaphragma sellae convexity are valuable ancillary findings.
- CT is suggested as the initial imaging modality due to its higher sensitivity for sellar-floor erosion.
