Semin Neurol 2012; 32(04): 320-331
DOI: 10.1055/s-0032-1331806
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Imaging of the Pituitary and Parasellar Region

Joshua W. Lucas
1   Department of Neurosurgery, University of Southern California, Los Angeles, California
,
Gabriel Zada
1   Department of Neurosurgery, University of Southern California, Los Angeles, California
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
29. Januar 2013 (online)

Abstract

The sellar and parasellar region is anatomically complex and encompasses many important vascular, endocrine, and neural structures. Pathology that arises within this region is often similarly complex, and requires a combination of endocrinologic, ophthalmologic, and neurologic examinations combined with advanced neuroimaging modalities. Magnetic resonance imaging (MRI) has become the gold standard for characterization of sellar and parasellar pathology due to the high contrast and detail it provides. Computed tomography (CT) allows for identification of bony involvement of lesions and also the general bony anatomy of the sellar region. Both modalities combined allow for complete characterization of sellar and parasellar pathology.

 
  • References

  • 1 Rennert J, Doerfler A. Imaging of sellar and parasellar lesions. Clin Neurol Neurosurg 2007; 109 (2) 111-124
  • 2 FitzPatrick M, Tartaglino LM, Hollander MD, Zimmerman RA, Flanders AE. Imaging of sellar and parasellar pathology. Radiol Clin North Am 1999; 37 (1) 101-121 , x
  • 3 Zee CS, Go JL, Kim PE, Mitchell D, Ahmadi J. Imaging of the pituitary and parasellar region. Neurosurg Clin N Am 2003; 14 (1) 55-80 , vi
  • 4 Pisaneschi M, Kapoor GK. Imaging the sella and parasellar region. Neuroimaging Clin N Am 2005; 15 (1) 203-219
  • 5 Zada G, Agarwalla PK, Mukundan Jr S, Dunn I, Golby AJ, Laws Jr ER. The neurosurgical anatomy of the sphenoid sinus and sellar floor in endoscopic transsphenoidal surgery. J Neurosurg 2011; 114 (5) 1319-1330
  • 6 Zada G, Lin N, Ojerholm E, Ramkissoon S, Laws ER. Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships. Neurosurg Focus 2010; 28 (4) E4
  • 7 Tsunoda A, Okuda O, Sato K. MR height of the pituitary gland as a function of age and sex: especially physiological hypertrophy in adolescence and in climacterium. AJNR Am J Neuroradiol 1997; 18 (3) 551-554
  • 8 Dietrich RB, Lis LE, Greensite FS, Pitt D. Normal MR appearance of the pituitary gland in the first 2 years of life. AJNR Am J Neuroradiol 1995; 16 (7) 1413-1419
  • 9 Elster AD. Modern imaging of the pituitary. Radiology 1993; 187 (1) 1-14
  • 10 Bartynski WS, Lin L. Dynamic and conventional spin-echo MR of pituitary microlesions. AJNR Am J Neuroradiol 1997; 18 (5) 965-972
  • 11 Rand T, Lippitz P, Kink E , et al. Evaluation of pituitary microadenomas with dynamic MR imaging. Eur J Radiol 2002; 41 (2) 131-135
  • 12 Zada G, Lin N, Laws Jr ER. Patterns of extrasellar extension in growth hormone-secreting and nonfunctional pituitary macroadenomas. Neurosurg Focus 2010; 29 (4) E4
  • 13 Snyder PJ. Clinically nonfunctioning pituitary adenomas. Endocrinol Metab Clin North Am 1993; 22 (1) 163-175
  • 14 Scotti G, Yu CY, Dillon WP , et al. MR imaging of cavernous sinus involvement by pituitary adenomas. AJR Am J Roentgenol 1988; 151 (4) 799-806
  • 15 Knosp E, Steiner E, Kitz K, Matula C. Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings. Neurosurgery 1993; 33 (4) 610-617 , discussion 617–618
  • 16 Tena-Suck ML, Salinas-Lara C, Arce-Arellano RI , et al. Clinico-pathological and immunohistochemical characteristics associated to recurrence/regrowth of craniopharyngiomas. Clin Neurol Neurosurg 2006; 108 (7) 661-669
  • 17 Eldevik OP, Blaivas M, Gabrielsen TO, Hald JK, Chandler WF. Craniopharyngioma: radiologic and histologic findings and recurrence. AJNR Am J Neuroradiol 1996; 17 (8) 1427-1439
  • 18 Hofmann BM, Kreutzer J, Saeger W , et al. Nuclear beta-catenin accumulation as reliable marker for the differentiation between cystic craniopharyngiomas and Rathke cleft cysts: a clinico-pathologic approach. Am J Surg Pathol 2006; 30 (12) 1595-1603
  • 19 Choi SH, Kwon BJ, Na DG, Kim JH, Han MH, Chang KH. Pituitary adenoma, craniopharyngioma, and Rathke cleft cyst involving both intrasellar and suprasellar regions: differentiation using MRI. Clin Radiol 2007; 62 (5) 453-462
  • 20 Zada G. Rathke cleft cysts: a review of clinical and surgical management. Neurosurg Focus 2011; 31 (1) E1
  • 21 Teramoto A, Hirakawa K, Sanno N, Osamura Y. Incidental pituitary lesions in 1,000 unselected autopsy specimens. Radiology 1994; 193 (1) 161-164
  • 22 Donovan JL, Nesbit GM. Distinction of masses involving the sella and suprasellar space: specificity of imaging features. AJR Am J Roentgenol 1996; 167 (3) 597-603
  • 23 Michael AS, Paige ML. MR imaging of intrasellar meningiomas simulating pituitary adenomas. J Comput Assist Tomogr 1988; 12 (6) 944-946
  • 24 Fujii K, Fujita N, Hirabuki N, Hashimoto T, Miura T, Kozuka T. Neuromas and meningiomas: evaluation of early enhancement with dynamic MR imaging. AJNR Am J Neuroradiol 1992; 13 (4) 1215-1220
  • 25 Morita A, Meyer FB, Laws Jr ER. Symptomatic pituitary metastases. J Neurosurg 1998; 89 (1) 69-73
  • 26 Abrams HL, Spiro R, Goldstein N. Metastases in carcinoma; analysis of 1000 autopsied cases. Cancer 1950; 3 (1) 74-85
  • 27 Schubiger O, Haller D. Metastases to the pituitary-hypothalamic axis. An MR study of 7 symptomatic patients. Neuroradiology 1992; 34 (2) 131-134
  • 28 Hanak BW, Zada G, Nayar VV , et al. Cerebral aneurysms with intrasellar extension: a systematic review of clinical, anatomical, and treatment characteristics. J Neurosurg 2012; 116 (1) 164-178
  • 29 Gay E, Sekhar LN, Rubinstein E , et al. Chordomas and chondrosarcomas of the cranial base: results and follow-up of 60 patients. Neurosurgery 1995; 36 (5) 887-896 , discussion 896–897
  • 30 Vates GE, Berger MS, Wilson CB. Diagnosis and management of pituitary abscess: a review of twenty-four cases. J Neurosurg 2001; 95 (2) 233-241
  • 31 Mazumdar A. Imaging of the pituitary and sella turcica. Expert Rev Anticancer Ther 2006; 6 (9) (Suppl. 09) S15-S22
  • 32 Kiliç T, Ekinci G, Seker A, Elmaci I, Erzen C, Pamir MN. Determining optimal MRI follow-up after transsphenoidal surgery for pituitary adenoma: scan at 24 hours postsurgery provides reliable information. Acta Neurochir (Wien) 2001; 143 (11) 1103-1126
  • 33 Parrott J, Mullins ME. Postoperative imaging of the pituitary gland. Top Magn Reson Imaging 2005; 16 (4) 317-323
  • 34 Yoon PH, Kim DI, Jeon P, Lee SI, Lee SK, Kim SH. Pituitary adenomas: early postoperative MR imaging after transsphenoidal resection. AJNR Am J Neuroradiol 2001; 22 (6) 1097-1104