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MR of the pituitary gland postsurgery: serial MR studies following transsphenoidal resection
T S Dina1, S H Feaster, E R Laws
1Department of Radiology, George Washington University Medical Center, Washington, DC 20037.
Purpose:
To determine the MR appearance of the pituitary gland in the early and late postoperative periods in order to distinguish operative complications more effectively and to establish a postoperative baseline.
Methods:
Ten patients were prospectively studied with MR following transsphenoidal resection of a pituitary tumor. Early postoperative studies were obtained at 2 to 8 days following surgery, late studies at 4 to 9 months in all patients and also at 12 to 16 months in five. Major observations were height of the pituitary mass and appearance of the surgical packing.
Results:
Within 8 days following surgery, the height of the pituitary mass was unchanged in two cases, increased in three, and only minimally decreased in five. All decreased in height (average 54%) by 4 to 9 months. Gelfoam packing completely (five) or nearly completely (three) resorbed leaving a normal-size, although deformed, pituitary gland. Fat-packed resection defects persisted (two).
Conclusions:
In the early postoperative period, the appearance of the pituitary gland is similar in size to its preoperative appearance. Subsequent involution with packing resorption yields a smaller, deformed pituitary gland.