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Microadenoma

Below is an MRI of a patient with a microadenoma. Spend some time really looking and understanding the dynamic contrast-enhanced coronal image. Watch how the contrast surrounds the adenoma. Also, look for the indirect signs of its presence. Is there deviation of the stalk? What about the floor of the sella? Look at the superior surface of the adenoma. Is it bowed upwards? 

Also spend a few minutes seeing how many structures you can name. Can you find the posterior pituitary bright spot? Do you remember what the cause of it is? 

On this page:

 

Presentation: 50-year-old woman with galactorrhea.

MRI pituitary

mri

Case credit: Frank Gaillard, rID: 16787

Video commentary

 

Key Points

  • look for indirect signs of a mass: bulkiness, deviation of the infundibulum
  • pay attention to the floor of the sella; where it joins the sphenoid septum will usually be a little depressed
  • look at the lateral margins of gland to determine if it bulges or invades the cavernous sinus; T1 coronal is good for this
  • watch contrast wash into the pituitary on dynamic sequences and get used to how it spreads through the gland
  • beware of assessing contrast enhancement when comparing non-fat-sat-T1 pre-contrast to fat-sat-T1 post-contrast (read this blog

 

 

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