Parasellar T2 Dark Sign on MR Imaging in Patients with Lymphocytic Hypophysitis

Nakata, Yasuhiro; Sato, Noriko; Masumoto, T.; Mori, Hiromu; Akai, Hiromu; Nobusawa, Hiroshi; Adachi, Yasuo; Oba, Hiroshi; Ohtomo, K

doi:10.3174/ajnr.a2201

Cited by 53 publications

(23 citation statements)

References 46 publications

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“…In PH patients, the posterior bright spot was absent in all 4, mucosal thickening was evident in 3 out of 4 (75%), and dural tail in 2 out of 4 (50%), T1 and T2 hyperintensity of the pituitary gland was present in all 4. Also, T2 dark signal intensity rim surrounding the pituitary gland was observed in 2 out of 4 (50%) (13). All patients satisfied criteria of the proposed radiological score to differentiate hypophysistis from adenoma (score <0) (14).…”

Section: Mri Featuresmentioning

confidence: 84%

Diabetes insipidus is an unfavorable prognostic factor for response to glucocorticoids in patients with autoimmune hypophysitis

Lupi

Cosottini

Caturegli³

et al. 2017

European Journal of Endocrinology

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Section: Mri Featuresmentioning

confidence: 84%

Diabetes insipidus is an unfavorable prognostic factor for response to glucocorticoids in patients with autoimmune hypophysitis

Lupi

Cosottini

Caturegli³

et al. 2017

European Journal of Endocrinology

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“…A). Lymphocytic hypophysitis could show homogenous enhancement with gadolinium and similar hypointensity on T2‐weighted image; however, in such a case no enlargement of the sella turcica could be observed. Among previously reported SCO cases, information on T2‐weighted image was available in only three cases, where isointensity to the gray matter with or without punctate hyperintensity areas within the masses .…”

Section: Discussionmentioning

confidence: 93%

Nonfunctional intra‐ and suprasellar tumor in a patient with visual disturbance and panhypopituitarism

Saito

Jinguji

Taniguchi³

et al. 2015

Neuropathology

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The patient, a 57-year-old woman, was admitted to a hospital because of a 2-year history of gradually deteriorating visual acuity and a 3-month history of easy fatigability. She had no family history of neurological disorders. An examination of her visual fields revealed bitemporal hemianopsia. Her corrected visual acuity with eye glasses was insufficient. An endocrine study revealed panhypopituitarism, with low fT3 and fT4 secretion, a very low range of cortisol, and an adrenocorticotrophic hormone level close to the lower limit. Replacement therapy with hydrocortisone and thyroid hormone was started. She showed no symptoms of diabetes insipidus. A brain MRI study demonstrated a mass lesion, measuring 17.5 × 17.5 × 30 mm, occupying the slightly enlarged sella turcica and extending to the suprasellar region, which exhibited either hypo-or iso-intensity on T2-weighted images (Fig. 1A). The hyper-intensity signal on T1-weighted image corresponding to the posterior lobe was not identified. The mass showed enhancement with gadolinium, but the contrast effect was weaker than that of the compressed pituitary gland (Fig. 1B,C). The optic chiasm was compressed markedly by the mass (Fig. 1B,C). The pituitary stalk was not identifiable. No invasion to the surrounding structures was evident. These clinical and radiological features appeared to be atypical for a nonfunctional pituitary macroadenoma, as the latter does not usually show low intensity on T2-weighted MRI. Moreover, patients with macroadenoma rarely show panhypopituitarism. Therefore, under a tentative diagnosis

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“…MRI shows a slightly lobulated lesion with intermediate signal on T1WI, heterogeneous low-intermediate and high signal on T2WI involving the pituitary lobe with thickened pituitary stalk, and prominent homogeneous or heterogeneous contrast enhancement involving the pituitary gland, pituitary stalk and dura. A characteristic finding includes a parasellar T2 dark sign, which helps in determining lymphocytic hypophysitis from a pituitary adenoma [ 72 ].…”

Section: Juxtasellar Lesionsmentioning

confidence: 99%

Magnetic resonance imaging of sellar and juxtasellar abnormalities in the paediatric population: an imaging review

et al. 2015

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The sellar and juxtasellar regions in the paediatric population are complex both anatomically and pathologically, with magnetic resonance imaging (MRI) being the “gold standard” imaging modality due to the high contrast of detail. Assessment requires a detailed understanding of the anatomy, embryology, pathophysiology and normal signal characteristics of the pituitary gland and surrounding structures in order to appropriately characterise abnormalities. This article aims to provide an overview of the imaging characteristics of developmental/congenital and acquired disease processes which affect the sellar and juxtasellar region in the paediatric population.Main Messages• The sellar region is anatomically complex and covers a wide pathology spectrum.• MRI is the key imaging modality to assess sellar and juxtasellar pathology.• Numerous developmental anomalies may not be discovered until adulthood.• Knowledge of pathology alerts and guides the clinician towards appropriate management.

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Parasellar T2 Dark Sign on MR Imaging in Patients with Lymphocytic Hypophysitis

Cited by 53 publications

References 46 publications

Diabetes insipidus is an unfavorable prognostic factor for response to glucocorticoids in patients with autoimmune hypophysitis

Diabetes insipidus is an unfavorable prognostic factor for response to glucocorticoids in patients with autoimmune hypophysitis

Nonfunctional intra‐ and suprasellar tumor in a patient with visual disturbance and panhypopituitarism

Magnetic resonance imaging of sellar and juxtasellar abnormalities in the paediatric population: an imaging review

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