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AJNR - American Journal of Neuroradiology

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Preoperative Location of the Pituitary Bright Spot in Patients with Pituitary Macroadenomas

Fabrice Bonneville^a,c, Yvan Narboux^a, Françoise Cattin^a, Emmanuel Rodière^a, Guy Jacquet^b and Jean-François Bonneville^a

^a Department of Neuroradiology, Hôpital Jean Minjoz, France
^b Department of Neurosurgery, Hôpital Jean Minjoz, France
^c Department of Neuroradiology, Hospital of the University of Pennsylvania, Philadelphia

View larger version (95K): [in a new window]   FIG 1. T1-weighted images (500/14/3) in a 37-year-old man with a 16-mm growth hormone (GH)–secreting macroadenoma with an infrasellar extension (group A) show the eutopic bright spot (arrowhead) within the sella, immediately anterior to the dorsum sella and mildly displaced on the left side. No postoperative data were available. A, Sagittal image. B, Axial image.

View larger version (93K): [in a new window]   FIG 2. T1-weighted images (500/14/3) in a 30-year-old woman with a 15-mm FSH- and LH-secreting macroadenoma (group A) illustrates a round, ectopic, bright spot (arrowhead) at the infundibulum. No postoperative DI occurred. A, Sagittal image. B, Coronal image.

View larger version (94K): [in a new window]   FIG 3. T1-weighted images (500/14/3) in a 34-year-old man with a 35-mm nonsecreting macroadenoma show a flattened ectopic posterior lobe (arrow), largely displaced from the midline. No postoperative diabetes insipidus occurred. A, Coronal image. B, Axial image.

View larger version (171K): [in a new window]   FIG 4. Sagittal T1-weighted image (500/14/3) in a 33-year-old woman with a 26-mm GH-secreting macroadenoma. No postoperative DI occurred. The figure 3 appearance of the high-signal-intensity area (arrows), which corresponds to ADH storage, is considered eutopic and ectopic at the same time. This shape is probably due to the compression of the hypothalamohypophyseal tract filled with ADH vesicles by the sellar diaphragm.