The Case of Cathy Nuremberg

Pituitary Gland Mri Abnormal

Fig. 11.31 a Here you see a representative MR section of Cathy Nuremberg's head. Do you notice any abnormalities? b Compare her image to this normal sagittal noncontrast MRI section of the pituitary gland. Typically the fine pituitary stalk (arrow) leads to the low-signal-intensity anterior adenohypophysis,

Fig. 11.31 a Here you see a representative MR section of Cathy Nuremberg's head. Do you notice any abnormalities? b Compare her image to this normal sagittal noncontrast MRI section of the pituitary gland. Typically the fine pituitary stalk (arrow) leads to the low-signal-intensity anterior adenohypophysis, which occupies most of the sella, and the smaller high-signal-intensity dorsal neurohypophysis. The brightness of the dorsal pituitary lobe is considered to be due to signal characteristics of its hormone content.

ciency). If the tumor is large it may enhance significantly after contrast administration (Fig. 11.32) and invade its vicinity.

After contrast administration, a microadenoma typically appears hypodense in comparison to the surrounding strongly enhancing pituitary gland. A macroadenoma, on the other hand, accumulates contrast rapidly and stands out against the compressed surrounding structures.

Craniopharyngioma: This slow-growing tumor arises from the squamous epithelial remnants of Rathke's pouch in children and young adults. This tumor has cystic, solid, and calcified components as well as a firm capsule (Fig. 11.33). From the suprasellar region it can extend into the third ventricle. Compression of perisellar structures may cause bitemporal hemianopia and even pituitary insufficiency may develop.

Miscellaneous perisellar tumors: Metastases to the skull base (Fig. 11.34a) as well as regional tumors such as

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