Varied microcirculation of pituitary adenomas at rapid, dynamic, contrast-enhanced MR imaging.
OBJECTIVE
Rapid, dynamic, contrast material-enhanced magnetic resonance imaging was performed to evaluate the early enhancement patterns of normal pituitary structures, macroadenomas, and microadenomas.


METHODS
A 1.5-T imager with a circularly polarized head coil was used on 40 patients referred for investigation of endocrinopathy, of neurologic deficit, or for follow-up of a previously documented pituitary tumor.


RESULTS
The technique provided a temporal resolution of one image per 1.25 seconds, allowing discrimination of primary arterial and secondary portal circulation enhancement phases of pituitary structures and tumors. Arterial-phase enhancement of 16 macroadenomas was observed, suggesting a primary arterial blood supply to these lesions. Five microadenomas showed minimal enhancement in the secondary portal circulation phase. A brief temporal phase was also captured, in which cavernous sinus invasion by tumor was visualized as a "filling defect" within the gadolinium-laden laterosellar venous spaces.


CONCLUSIONS
The technique reveals the microcirculatory dynamics associated with pituitary adenomas and suggests a dominant arterial blood supply for macroadenomas. It can supplement routine spin-echo imaging for determination of cavernous sinus invasion. Limitations related to section positioning, resolution, and signal-to-noise ratio exist.
Department of Radiology, MetroHealth Medical Center, Cleveland, Ohio 44109-1998.
D A
DA
Finelli
B
B
Kaufman
D000236:Adenoma / Q000098:blood supply* / Q000188:drug therapy / Q000601:surgery; D000328:Adult; D000368:Aged; D002339:Carotid Arteries / Q000473:pathology; D002426:Cavernous Sinus / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage; D004338:Drug Combinations; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008536:Meglumine; D008833:Microcirculation; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid; D010902:Pituitary Gland / Q000098:blood supply*; D010911:Pituitary Neoplasms / Q000098:blood supply* / Q000188:drug therapy / Q000601:surgery; D013997:Time Factors
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA