Three-dimensional magnetic resonance-based morphometry of pituitary stalk

Veeramani, Raveendranath; Nagarajan, Krishnan; Amirthalingam, Umamageswari; Swathi, Srinidhi; Kavitha, Thangaraj

doi:10.1007/s11547-018-0956-6

Cited by 15 publications

(8 citation statements)

References 13 publications

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“…The following radiological features were recorded: the presence or absence of the posterior hypophyseal bright spot; the pituitary size (the height of the anterior pituitary was measured on sagittal T1-weighted images) and the gland was characterized as normal or enlarged (height >7 mm); the width of the pituitary stalk, measured in its proximal, medial and distal portions on both coronal and sagittal sequences; the morphology of the stalk (characterized as tubular, V-shaped, round or pyramidal according to the classification reported by Turcu et al (3)); and the enhancement pattern of the pituitary stalk (homogenous/ non-homogenous). Based on the previously reported normal dimensions of the hypothalamic-pituitary axis on MRI (15,16,17,18), the pituitary stalk was considered enlarged when its largest diameter was greater than 4.0 mm in its proximal portion at the level of the optic chiasm, 2.8 mm in its medial portion and/or 2.5 mm in its distal portion at the level of pituitary insertion. A similar evaluation was made on subsequent MRI scans to detect any changes regarding the width of pituitary stalk.…”

Section: Pituitary Mri Evaluationmentioning

confidence: 99%

Central diabetes insipidus and pituitary stalk thickening in adults: distinction of neoplastic from non-neoplastic lesions

Kazakou

Balériaux

Alexopoulou

et al. 2020

European Journal of Endocrinology

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Context Association of central diabetes insipidus (CDI) and pituitary stalk thickening (PST) may have several etiologies (including malignancies) and differential diagnosis remains often difficult. Objective The purpose of this study was to identify which clinical, biochemical or radiological features could help clinicians to make an etiological diagnosis, especially distinguishing neoplastic from non-neoplastic pituitary stalk lesions. Design and methods We retrospectively analyzed clinical, biochemical, radiological and histological data of 38 adult patients diagnosed with CDI and PST of proven etiology. Results Of the 38 pituitary stalk lesions included, 11 (29%) were neoplastic. A histopathological diagnosis was obtained in 22/38 (58%) patients. The three most frequently observed etiologies of PST were neuroinfundibulitis (34%), germinoma (21%) and histiocytosis (18%). Pituitary stalk thickness was larger for neoplastic lesions, particularly germinomas. Male gender and a very young age were statistically associated with a risk of germinoma. At least one anterior pituitary deficit was observed in nearly 60% of patients. Patients with neoplastic PST were more affected by multiple anterior pituitary dysfunction than patients with benign PST. A high serum prolactin level was individually the best predictor of a neoplastic origin (90% sensitivity and 60% specificity for a serum prolactin level 1.27-fold above the normal upper limit (ULN)). Conclusion We confirm a relatively high risk of malignancy in adult patients presenting with the association of CDI and PST. Young age, male gender, a very large thickening of the stalk, multiple anterior pituitary deficits and prolactin above 1.3× ULN increase the likelihood of a neoplastic origin.

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Section: Pituitary Mri Evaluationmentioning

confidence: 99%

Central diabetes insipidus and pituitary stalk thickening in adults: distinction of neoplastic from non-neoplastic lesions

Kazakou

Balériaux

Alexopoulou

et al. 2020

European Journal of Endocrinology

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“…In particular, the 3 Tesla MRI allows a better identification of the pituitary microadenomas and a greater anatomical detail for the study of the parasellar region, useful for evaluating possible invasion of the cavernous sinus (20,21). This is made possible thanks to the use of 3D T1-w sequences with a reduced slice thickness (1-2 mm), which allows to obtain high quality images while minimizing susceptibility artifacts in the sellar and parasellar regions (22,23). However, high-field imaging is not free from artifacts.…”

Section: Magnetic Resonance Imaging and Its Rule In The Diagnostic Workupmentioning

confidence: 99%

Pituitary magnetic resonance imaging vs. bilateral inferior petrosal sinus sampling: comparison between non-invasive and invasive diagnostic techniques for Cushing’s disease—a narrative review

Tortora¹,

Negro²,

Briganti³

et al. 2020

Gland Surg

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Cushing's syndrome is a pathological clinical condition caused by an exposure of elevated cortisol levels over a long period of time. It is therefore essential to establish what the cause of hypercortisolism is.In most cases (about 80%) the pathological process is due to adrenocorticotropic hormone (ACTH), while in a minor part of the cases (about 20%) the cause is represented by a pathology of the adrenal glands and therefore not related to ACTH. Most patients with ACTH dependent Cushing's syndrome have a pituitary microadenoma; in the remaining cases (30%), the high level of cortisol is linked to an ectopic secretion of ACTH. Surgical removal of the pituitary adenoma represents the treatment of choice in Cushing's disease (CD) patients; it is therefore necessary to identify and precisely locate the pituitary tumour responsible for the secretion of ACTH. Adequate diagnostic information is very often, even with magnetic resonance imaging (MRI), and in these cases we rely on bilateral inferior petrosal sinuses sampling (BIPSS). This procedure is considered the gold standard method for the diagnosis, but like any other diagnostic method it is not free from erroneous results such as false positives or false negatives.

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“…The appearance, including volume, depth and length, of the normal PS has been described on T1-and T2-weighted MRI images acquired on a 3T (Satogami et al 2010) and a 1.5T scanner (Raveendranath et al 2019). Other groups highlighted the importance of assessing the width of the infundibular recess as it may affect other parameters such as PS thickness (Raveendranath et al 2019). One can delineate the infundibular recess from the PS better on high-resolution images [e.g., .3 mm isotropic (Tullo et al 2018)] as shown in Fig.…”

Section: The Psmentioning

confidence: 99%

Imaging the pituitary in psychopathologies: a review of in vivo magnetic resonance imaging studies

2019

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The pituitary gland (PG) is a key component of the essential endocrine systems in humans and animals, including the hypothalamic-pituitary-adrenal, hypothalamic-pituitary-gonadal, and hypothalamic-pituitary-thyroid axes. Structural changes in the PG are observed in a number of psychiatric disorders. Psychiatric disorders are typically characterized by subtle, time-dependent anatomical changes in the brain, and their study necessitates highly powered, longitudinal investigations. Structural magnetic resonance imaging (MRI) is a non-invasive technology that is ideally suited to detect changes in anatomical structures over time. In this paper, we will review the main findings on pituitary function and structure in the context of healthy development and of psychiatric disorders, with particular emphasis on MRI studies. The latter have not always succeeded in providing a clear theoretical framework of mental disorders, which may be explained by low resolution and differences in preprocessing methods, imprecise segmentation rules that do not account for the anatomical and functional specificity of the anterior and posterior lobes of the PG, and inadequate categorization of clinical subjects. We review those limitations and propose solutions for future research.

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Three-dimensional magnetic resonance-based morphometry of pituitary stalk

Cited by 15 publications

References 13 publications

Central diabetes insipidus and pituitary stalk thickening in adults: distinction of neoplastic from non-neoplastic lesions

Central diabetes insipidus and pituitary stalk thickening in adults: distinction of neoplastic from non-neoplastic lesions

Pituitary magnetic resonance imaging vs. bilateral inferior petrosal sinus sampling: comparison between non-invasive and invasive diagnostic techniques for Cushing’s disease—a narrative review

Imaging the pituitary in psychopathologies: a review of in vivo magnetic resonance imaging studies

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