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Research ArticleADULT BRAIN

Role of High-Resolution Dynamic Contrast-Enhanced MRI with Golden-Angle Radial Sparse Parallel Reconstruction to Identify the Normal Pituitary Gland in Patients with Macroadenomas

R. Sen, C. Sen, J. Pack, K.T. Block, J.G. Golfinos, V. Prabhu, F. Boada, O. Gonen, D. Kondziolka and G. Fatterpekar
American Journal of Neuroradiology June 2017, 38 (6) 1117-1121; DOI: https://doi.org/10.3174/ajnr.A5244
R. Sen
aFrom the New York University School of Medicine, NYU Langone Medical Center, New York, New York.
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C. Sen
aFrom the New York University School of Medicine, NYU Langone Medical Center, New York, New York.
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J. Pack
aFrom the New York University School of Medicine, NYU Langone Medical Center, New York, New York.
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K.T. Block
aFrom the New York University School of Medicine, NYU Langone Medical Center, New York, New York.
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J.G. Golfinos
aFrom the New York University School of Medicine, NYU Langone Medical Center, New York, New York.
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V. Prabhu
aFrom the New York University School of Medicine, NYU Langone Medical Center, New York, New York.
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F. Boada
aFrom the New York University School of Medicine, NYU Langone Medical Center, New York, New York.
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O. Gonen
aFrom the New York University School of Medicine, NYU Langone Medical Center, New York, New York.
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D. Kondziolka
aFrom the New York University School of Medicine, NYU Langone Medical Center, New York, New York.
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G. Fatterpekar
aFrom the New York University School of Medicine, NYU Langone Medical Center, New York, New York.
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    Fig 1.

    A, Contrast-enhanced sagittal T1WI demonstrates a macroadenoma. B, GRASP dynamic MR imaging through the sella demonstrates the macroadenoma extending into the right cavernous sinus. A focal area of increased enhancement is seen along the left lateral aspect of the lesions. C, Postprocessed MR permeability peak scan demonstrates a focal area of increased contrast uptake (ROI 1) from the left lateral aspect of the sella compared with the macroadenoma (ROI 2). D, The enhancement-time curve confirms that the normal pituitary gland, localized along the left lateral aspect of the sella, enhances earlier and more robustly than the macroadenoma.

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    Fig 2.

    A, Contrast-enhanced sagittal T1WI through the sella demonstrates a heterogeneously enhancing lesion expanding the sella and extending into the suprasellar compartment, suggestive of a macroadenoma. B, Contrast-enhanced coronal T1WI demonstrates the macroadenoma. The heterogeneous enhancement within the lesion makes it difficult to localize the pituitary gland. C, GRASP dynamic study at 90 seconds (early dynamic phase) demonstrates more prominent enhancement along the left superolateral aspect of the lesion. D, Wash-in permeability study with ROIs placed within the central, heterogeneous portion of the lesion (ROI 2) and the more avidly enhancing region seen along its left superolateral aspect (ROI 1). E, Enhancement-time curves demonstrate a difference in rate and peak contrast uptake for each ROI. The ROI from the more avidly enhancing component seen along the left superolateral aspect of the lesion demonstrates a more pronounced peak enhancement than the more central, heterogeneously enhancing component. These curves validate that the pituitary gland is localized along the left superolateral aspect of this lesion, which was also confirmed at the operation.

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American Journal of Neuroradiology: 38 (6)
American Journal of Neuroradiology
Vol. 38, Issue 6
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R. Sen, C. Sen, J. Pack, K.T. Block, J.G. Golfinos, V. Prabhu, F. Boada, O. Gonen, D. Kondziolka, G. Fatterpekar
Role of High-Resolution Dynamic Contrast-Enhanced MRI with Golden-Angle Radial Sparse Parallel Reconstruction to Identify the Normal Pituitary Gland in Patients with Macroadenomas
American Journal of Neuroradiology Jun 2017, 38 (6) 1117-1121; DOI: 10.3174/ajnr.A5244

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Role of High-Resolution Dynamic Contrast-Enhanced MRI with Golden-Angle Radial Sparse Parallel Reconstruction to Identify the Normal Pituitary Gland in Patients with Macroadenomas
R. Sen, C. Sen, J. Pack, K.T. Block, J.G. Golfinos, V. Prabhu, F. Boada, O. Gonen, D. Kondziolka, G. Fatterpekar
American Journal of Neuroradiology Jun 2017, 38 (6) 1117-1121; DOI: 10.3174/ajnr.A5244
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