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Review
. 2019 Sep;8(Suppl 3):S208-S215.
doi: 10.21037/gs.2019.06.08.

High-resolution magnetic resonance imaging at 3T of pituitary gland: advantages and pitfalls

Marco Varrassi  1 , Flavia Cobianchi Bellisari  2 , Federico Bruno  2 , Pierpaolo Palumbo  2 , Raffaele Natella  3 , Nicola Maggialetti  4 , Massimo De Filippo  5 , Ernesto Di Cesare  2 , Antonio Barile  2 , Carlo Masciocchi  2 , Ferdinando Caranci  6 , Alessandra Splendiani  2
Affiliations
Review

High-resolution magnetic resonance imaging at 3T of pituitary gland: advantages and pitfalls

Marco Varrassi et al. Gland Surg. 2019 Sep.

Abstract

Magnetic resonance imaging (MRI) is the primary imaging tool for the evaluation of pituitary gland pathology. In the last decades, MRI with high-field scanners has become widely used in clinical practice, leading to significant improvements in image quality mainly thanks to a superior spatial resolution and signal intensity. Moreover, several advanced functional MRI sequences have been implemented for pituitary imaging, providing valuable information in diagnostic and presurgical planning of pituitary adenomas. Higher field strength presents however some technical pitfalls to be aware of. The purpose of this article is to review the state of the art of high-resolution MRI of the pituitary gland at 3 Tesla (3T), with a particular focus on the main benefits and the possible limitations of higher field imaging.

Keywords: 3 Tesla (3T); Pituitary gland; diffusion-weighted imaging (DWI); magnetic resonance imaging (MRI); spectroscopy.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Sagittal T1 multi echo multiplanar (MEMP) spin-echo (SE), 3 mm slice thickness sequence (A) at 3T showing normal anatomy of the pituitary gland. Coronal 3D T1 fast spoiled gradient echo (FSPGR) 1 mm slice thickness sequence (B) after intravenous administration of gadolinium showing optimal visualization of the pituitary stalk and homogenous parenchymal enhancement.
Figure 2
Figure 2
Coronal T1 spin-echo (SE) sequence after dynamic contrast enhancement at 3T scanner showing a 3 mm area of delayed enhancement in the left portion of adenohypophysis, consistent with microadenoma.
Figure 3
Figure 3
Sagittal T1 multi echo multiplanar (MEMP) spin-echo (SE) 3 mm slice thickness sequence (A) and coronal T1 MEMP SE 3 mm slice thickness (B) at 3T scanner, both performed after administration of contrast medium, showing inhomogeneous solid mass involving sellar and suprasellar region causing mild displacement of optic chiasm, likely referable to macroadenoma.
Figure 4
Figure 4
Axial T1 fat-suppressed fast spoiled gradient echo (FSPGR) 1 mm slice thickness sequence after administration of contrast medium at 3T scanner, showing pathological enhancement involving right orbital apex and anterior aspect of ipsilateral cavernous sinus, encasing the intracanalicular portion of optic nerve. A case of Tolosa-Hunt syndrome.
See this image and copyright information in PMC

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