title: Assessment of hemorrhage in pituitary macroadenoma by T2*-weighted gradient-echo MR imaging.
abstract: OBJECTIVE
  Intratumoral hemorrhage occurs frequently in pituitary macroadenoma and manifests as pituitary apoplexy and recent or old silent hemorrhage. T2*-weighted gradient-echo (GE) MR imaging is the most sensitive sequence for the detection of acute and old intracranial hemorrhage. T2*-weighted GE MR imaging was used to investigate intratumoral hemorrhage in pituitary macroadenomas.
  
  
  METHODS
  Twenty-five consecutive patients who underwent total or subtotal resection of pituitary macroadenoma with heights from 17 to 53 mm, including 1 patient with classic pituitary apoplexy, underwent MR imaging before surgery, including T2*-weighted GE MR imaging. For histologic assessment of the hemorrhage in whole surgical specimens, we used hematoxylin-eosin staining.
  
  
  RESULTS
  T2*-weighted GE MR imaging detected various types of dark lesions, such as "rim," "mass," "spot," and "diffuse" and combinations, indicating clinical and subclinical intratumoral hemorrhage in 12 of the 25 patients. The presence of intratumoral dark lesions on T2*-weighted GE MR imaging correlated significantly with the hemorrhagic findings on T1- and T2-weighted MR imaging (P < .02 and <.01, respectively), and the surgical and histologic hemorrhagic findings (P < .001 and <.001, respectively).
  
  
  CONCLUSIONS
  T2*-weighted GE MR imaging could detect intratumoral hemorrhage in pituitary adenomas as various dark appearances. Therefore, this technique might be useful for the assessment of recent and old intratumoral hemorrhagic events in patients with pituitary macroadenomas.
authors: Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan. nstosaka@med.gunma-u.ac.jp
authors: M
authors: M
authors: Tosaka
authors: N
authors: N
authors: Sato
authors: J
authors: J
authors: Hirato
authors: H
authors: H
authors: Fujimaki
authors: R
authors: R
authors: Yamaguchi
authors: H
authors: H
authors: Kohga
authors: K
authors: K
authors: Hashimoto
authors: M
authors: M
authors: Yamada
authors: M
authors: M
authors: Mori
authors: N
authors: N
authors: Saito
authors: Y
authors: Y
authors: Yoshimoto
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D000328:Adult; D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010899:Pituitary Apoplexy / Q000175:diagnosis; D010911:Pituitary Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology