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AJNR - American Journal of Neuroradiology

Published ahead of print on February 22, 2008
doi: 10.3174/ajnr.A1016

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Sequential Pituitary MR Imaging in Sheehan Syndrome: Report of 2 Cases

J. Kaplun^a, C. Fratila^c, A. Ferenczi^a, W.C. Yang^b, G. Lantos^d, A.M. Fleckman^a and U.K. Schubart^c

^a Department of Medicine, Beth Israel Medical Center, University Hospital and Manhattan Campus for the Albert Einstein College of Medicine, New York, NY
^b Department of Radiology, Beth Israel Medical Center, University Hospital and Manhattan Campus for the Albert Einstein College of Medicine, New York, NY
^c Department of Medicine, Jacobi Medical Center, Bronx, NY
^d Department of Radiology, Jacobi Medical Center, Bronx, NY

View larger version (93K): [in this window] [in a new window]   Fig 1. Case 1. Coronal (left) and sagittal (right) gadolinium enhanced T1-weighted MR images on postpartum day 26 show central low signal intensity and peripheral enhancement in the pituitary gland.

View larger version (86K): [in this window] [in a new window]   Fig 2. Case 1. Coronal (left) and sagittal (right) noncontrast T1-weighted MR images 6 months later show marked diminution in the size of the pituitary gland. There is CSF signal intensity in the sella ("empty sella").

View larger version (86K): [in this window] [in a new window]   Fig 3. Case 2. Coronal (A) and sagittal (B) gadolinium-enhanced T1-weighted MR images on postpartum day 6 show a large low signal intensity sellar lesion with enhancement of the rim. There is extension into the suprasellar cistern, and the lesion abuts but does not compress the optic chiasm.

View larger version (76K): [in this window] [in a new window]   Fig 4. A and B, Case 2. At 5 weeks postpartum, the lesion is markedly smaller and no longer protrudes into the suprasellar cistern (image layout same as Fig 3).

View larger version (84K): [in this window] [in a new window]   Fig 5. A and B, Case 2. At 11 months postpartum, the sellar contents are markedly smaller, with a thin rim of enhancing tissue along the sellar floor (image layout same as Figs 3 and 4). CSF is noted in the sella ("empty sella").