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

MR imaging findings of LYH and pituitary adenomas are similar, but the therapeutic strategies are completely different. The purpose of this study was to evaluate sellar and parasellar MR imaging findings in patients with both diseases, as well as characteristic clinical findings. Clinical findings,...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2010-11, Vol.31 (10), p.1944-1950
Main Authors: NAKATA, Y, SATO, N, MASUMOTO, T, MORI, H, AKAI, H, NOBUSAWA, H, ADACHI, Y, OBA, H, OHTOMO, K
Format: Article
Language:English
Subjects:
Adenoma
Adenoma - pathology
Adolescent
Adult
Aged
Biological and medical sciences
Child
Diagnosis, Differential
Female
Head and Neck
Human viral diseases
Humans
Hypopituitarism - pathology
Infectious diseases
Investigative techniques, diagnostic techniques (general aspects)
Lymphocytosis - pathology
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Nervous system
Pituitary Gland - pathology
Pituitary Neoplasms - pathology
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Retrospective Studies
Sella Turcica - pathology
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Young Adult
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Summary:MR imaging findings of LYH and pituitary adenomas are similar, but the therapeutic strategies are completely different. The purpose of this study was to evaluate sellar and parasellar MR imaging findings in patients with both diseases, as well as characteristic clinical findings. Clinical findings, including endocrinologic study and MR images of 20 patients with LYH and 22 patients with pituitary adenoma, were retrospectively reviewed. We evaluated the MR images in relation to the following: 1) the PPHI on T1-weighted images, 2) thickened stalk (>3.5 mm), 3) pituitary symmetry, 4) pituitary enhancement pattern, 5) a dural tail, and 6) parasellar signal intensity on T2- and T1-weighted images. Between patients with LYH and those with pituitary adenoma, a significant difference was identified for the number of patients with loss of PPHI, thickened stalk, pituitary symmetry, homogeneous enhancement, and parasellar dark signal intensity on T2-weighted images by statistical analysis (Fisher exact probability test, P < .05). Among them, only parasellar dark signal intensity on T2-weighted images had no false-positive cases. The parasellar T2 dark sign can be a specific finding used to distinguish pituitary adenoma from LYH.
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A2201