Assessment of T2-Weighted Coronal Magnetic Resonance Images in the Investigation of Pituitary Lesions

Magnetic resonance imaging is the most important diagnostic method in the investigation of the pituitary lesions. Our aim is to determine whether T2-weighted coronal images may be helpful in the evaluation of the pituitary gland with suspected pituitary adenomas. One hundred and sixty-seven patients were examined prospectively with T2-weighted coronal and T1-weighted coronal images enhanced with intravenous contrast material. The images were evaluated for the presence, the size, the location, and the ancillary signs including sellar floor erosion or ballooning, infindibulary deviation, convexity of the superior border of the gland, diffuse enlargement of the gland, and the invasion of the cavenous sinuses on both images. In forty-six (28%) patients lesions were revealed on both sequences. In twenty-one (12%) patients the lesions that were revealed on the T1-weighted images were not detected on the T2-weighted images. Positive predictive value, negative predictive value, sensitivity, specificity, and diagnostic accuracy rates of T2-weighted coronal images on the detection of the presence of lesions were 100%, 17.4%, 68.7%, 100%, and 87.4%, respectively. Both T2-weighted coronal and T1-weighted coronal images enhanced with intravenous gadolinium-based contrast material are important in the diagnosis of pituitary adenomas. T2-weighted coronal images could be used as a screening tool for the primary evaluation of the pituitary gland. 1. Introduction Pituitary adenomas are the most common pathologies encountered in the sellar area [1]. They also either may be clinically silent or can cause a variety of symptoms related to compression of adjacent structures and hormone secretion. Today, magnetic resonance (MR) imaging is usually the first diagnostic method in the investigation of pituitary adenomas. The detection of adenomas on MR imaging depends on the image contrast between adenoma and normal pituitary tissue. There are also ancillary signs including sellar floor erosion or ballooning, infindibulary deviation, convexity of the superior border of the gland, diffuse enlargement of the gland, and the invasion of the cavernous sinuses [2]. T1-weighted coronal images enhanced with intravenous gadolinium-based contrast material (IV-GBCM) provide higher detection rates of adenomas. T2-weighted coronal images may be important for the detection of the pituitary adenomas without administration of IV-GBCM. Therefore, time and account of the examinations will be decreased and the cost effectiveness will be increased. Also possible harmful side effects of the IV-GBCM