Preoperative location of the pituitary bright spot in patients with pituitary macroadenomas.
OBJECTIVE
The purpose of this study was to determine the location of the pituitary bright spot in patients with pituitary macroadenomas before surgery.


METHODS
A total of 54 patients with pituitary macroadenomas were retrospectively included in this study. Nonenhanced spin-echo T1-weighted MR images were reviewed to identify the location of the high-intensity-signal posterior pituitary lobe that indicates antidiuretic hormone (ADH) storage. Images were acquired with a 1.5-T machine by using 3-mm-thick contiguous sections in two or three orthogonal planes and a 300 x 512 matrix.


RESULTS
The bright spot corresponding to ADH storage was identified in 44 (81%) patients. Two groups of patients were defined by the height of the macroadenoma: Group A patients (n = 27) had pituitary macroadenomas less than 20 mm in height, and group B (n = 27) had macroadenomas 20 mm or larger. In group A, the bright spot was identified in 25 patients (93%); it was located in the sella in 24 of these cases (96%). In group B, the bright spot was identified in 19 patients (70%); it was in an ectopic location in 14 of these cases (74%).


CONCLUSIONS
MR imaging can be used to depict the pituitary bright spot in most patients with pituitary macroadenomas before surgery. The bright spot is usually identified at its expected location within the sella in patients with pituitary macroadenomas less than 20 mm in height, whereas an ectopic location is common when pituitary macroadenomas are larger more than 20 mm.
Bonneville
Fabrice
F
Department of Neuroradiology, Hôpital Jean Minjoz, France.
Narboux
Yvan
Y
Cattin
Françoise
F
Rodière
Emmanuel
E
Jacquet
Guy
G
Bonneville
Jean-François
JF
D000236:Adenoma / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010904:Pituitary Gland, Posterior / Q000378:metabolism / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000601:surgery; D012189:Retrospective Studies; D014667:Vasopressins / Q000378:metabolism
D014667:Vasopressins