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Optic Nerve Hyperintensity on T2-Weighted Images among Patients with Pituitary Macroadenoma: Correlation with Visual Impairment

A.M. Tokumarua, I. Sakatab, H. Teradae, S. Kosudab, H. Nawashiroc and M. Yoshiid

a Department of Radiology, Tokyo Metropolitan Geriatric Hospital, Tokyo Japan
b Department of Radiology, National Defense Medical College, Saitama Japan
c Department of Neurosurgery, National Defense Medical College, Saitama Japan
d Department of Ophthalmology, National Rehabilitation Center for Persons with Disabilities, Saitama Japan
e The 2nd Department of Radiology, Toho University School of Medicine, Tokyo Japan


Figure 1
Figure 1
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  		Fig 1. Degree of optic chiasmal compression. A, No compression to optic chiasma (–). B, Compression of less than half of the optic chiasm (+). C, Compression with marked thinning (++).


Figure 2
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  		Fig 2. Correlation between abnormal signal intensity of optic nerve and tumor size.


Figure 3
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  		Fig 3. Correlation between abnormal signal intensity of optic nerve and optic chiasm compression.


Figure 4
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  		Fig 4. Correlation between abnormal signal intensity of optic nerve and improvement after treatment of VA.


Figure 5
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  		Fig 5. Case 3, a 42-year-old woman whose disease duration was 6 months. Right VA disturbance was recognized (right VA = 0.02; left VA = 1.5). A, Pituitary macroadenoma markedly compressed the optic chiasm especially the right side (white arrows). B–E, Hyperintensity was recognized in the right optic nerve on T2-weighted image (arrows). F–H, Hyperintensiy in the right optic nerve lasted for 2 years after the tumor reduction (arrows).


Figure 6
Figure 6
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  		Fig 6. Case 17, a 58-year-old man, whose disease duration from the initial examination to the operation was 26 months. VA was not stable, though fixed VA disturbance was not recognized on the initial examination. A, Pituitary adenoma compressed the optic chiasm. B, Hyperintensiy of the optic nerve was not shown (arrows) on the initial examination. C, Right-side perioptic subarachnoid space dilated slightly on the initial examination (arrow). D and E, Tumor reduction was performed 26 months after the initial examination. Hyperintensity was shown in the bilateral optic nerve ventral to the optic chiasm (D, white arrows) and bilateral perioptic subarachnoid space dilated markedly (E, white arrows), probably representing atrophic change of the optic nerves.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X