Hypothalamic and Pituitary Imaging Flashcards Preview

DEMS: Unit III > Hypothalamic and Pituitary Imaging > Flashcards

Flashcards in Hypothalamic and Pituitary Imaging Deck (16):
1

Available imaging modalities

  • MRI is only logical thing to order
    • Can do a CT if MRI is contraindicated (ex. cardiac pacemaker, nerve root stimulators)
  • No ionizing radiation
  • Can be performed in any plane
  • Measures 3 things only:
    • Proton density
    • T1 relaxation rate
    • T2 relaxation rate
  • Contrast only affects T1

2

T1 and T2: relaxation rate, colors, common bright items

3

Appearance of hypothalamic-pituitary structures on imaging (1 of 3, non-contrast primary T1)

4

Appearance of hypothalamic-pituitary structures on imaging (2 of 3, non-contrast primary T1)

5

Appearance of hypothalamic-pituitary structures on imaging (3 of 3, post-constrast T1)

6

Normal appearance of pituitary and sella on imaging (T1 weighted)

7

Normal appearance of pituitary and sella on imaging (T2 weighted)

8

Radiologic appearance of macroadenoma

  • Remodels bone, doesn't bust through (insidious)
  • Dumbbell shape as it squeezes through sella
  • Mass effets come from growth --> optic chiasm, cavernous sinuses, can collapse arteries
  • Cavernous sinuses are dural folds (difficult to approach by neurosurgery)
  • Regardless of size and expansion: still staged as adenoma, not carcinoma until distant metastases present

9

Radiologic diagnosis? 

Hyperplasia of pituitary

10

Radiologic diagnosis?

Pituitary microadenoma 

  • Right side of adenohypophysis is enlarged
  • Focal decreased enhancement in this region
  • T2 signal is low

11

Radiologic diagnosis? 

  • Giant pituitary macroadenoma (> 4 cm) 
  • Invasion of clivus, sphenoid sinus, ethmoid air cells, and nasal vault

12

Radiologic diagnosis? 

Rathke Cleft cyst

13

Radiologic diagnosis? 

Lymphocytic hypophysitis

14

Radiologic diagnosis? 

Craniopharyngioma: adamantinomatous type (2 year old child, most commonly calcified in children)

15

Radiologic diagnosis? 

Craniopharyngioma: papillary type

16

Radiologic diagnosis? 

Meningioma