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title: "Pituitary Anomalies"
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docid: "09ca9b54-a3d9-43fd-a9cc-4c0212b578a1"
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authors:
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- key: "8d5254e9-8dda-478b-8f08-bdee97a32c79"
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value: "Karen L. Salzman, MD, FACR"
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- key: "99e1aff7-f42c-43a0-95ae-d89c8551aa01"
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value: "Kevin R. Moore, MD"
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breadcrumbs:
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-
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name: "Brain"
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slug: "brain"
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treeNodeId: "6d8829f1-14d7-45af-8675-255189aa526a"
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-
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name: "Diagnosis"
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slug: "diagnosis"
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treeNodeId: "51c00394-446e-4a38-94af-d3b1d14d34e8"
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-
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name: "Anatomy-Based Diagnoses"
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slug: "anatomy-based-diagnoses"
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treeNodeId: "529d3e33-f508-498c-bc70-cf962e81e629"
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-
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name: "Sella and Pituitary"
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slug: "sella-and-pituitary"
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treeNodeId: "9afaeeb6-661c-49be-b55f-5bdc1c98a53e"
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-
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name: "Congenital"
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slug: "congenital"
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treeNodeId: "89554ca5-701e-4263-97d7-60305db01bd9"
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-
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name: "Pituitary Anomalies"
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slug: "pituitary-anomalies"
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treeNodeId: null
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category: "Brain"
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cmeTopicId: "e00741a7-e510-4b96-8def-71e0a27a02a0"
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documentVersionId: "2a6d3547-ae03-4685-a50b-8f6d25dc468e"
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imageCount: 15
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lastUpdated: "07/15/20"
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pageDescription: "Pituitary Anomalies"
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pageKeywords: "Brain, Diagnosis, Anatomy-Based Diagnoses, Sella and Pituitary, Congenital, Pituitary Anomalies"
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pageTitle: "Pituitary Anomalies | STATdx"
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enhancedTitle: "Pituitary Anomalies"
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type: "DX"
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references: true
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breadcrumbs:
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- "Brain"
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- "Diagnosis"
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- "Anatomy-Based Diagnoses"
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- "Sella and Pituitary"
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- "Congenital"
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- "Pituitary Anomalies"
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---
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# KEY FACTS
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- ## Terminology
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- Congenital anomalies of pituitary stalk → potential hypothalamic/pituitary axis malfunction
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- ## Imaging
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- Posterior pituitary ectopia (PPE)
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- No (or tiny) pituitary stalk, ectopic posterior pituitary (EPP) on midline sagittal T1WI MR
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- Look for associated anomalies: Heterotopia, optic nerve hypoplasia, corpus callosum anomalies
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- Duplicated pituitary gland/stalk (DP)
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- 2 pituitary stalks on coronal view, thick tuber cinereum on midline sagittal view
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- ## Top Differential Diagnoses
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- PPE
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- Surgical or traumatic stalk transection
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- Central diabetes insipidus
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- Hypothalamic lipoma (in tuber cinereum)
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- DP
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- Dilated infundibular recess of 3rd ventricle ("pseudoduplication")
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- Tuber cinereum hamartoma
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- ## Pathology
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- PPE: Genetic mutation → defective neuronal migration during embryogenesis
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- DP: Genetic mutation unknown; may constitute polytopic field defect due to splitting of notochord
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- ## Clinical Issues
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- PPE: Short stature
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- DP: Unsuspected finding on craniofacial imaging for other indications
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- ## Diagnostic Checklist
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- PPE: Assess optic and olfactory nerves, frontal cortex
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- DP: Oral tumors compromise airway patency
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# TERMINOLOGY
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- ## Synonyms
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- Ectopic pituitary bright spot
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- ## Definitions
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- Congenital anomalies of pituitary stalk → potential hypothalamic/pituitary axis malfunction
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# IMAGING
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- ## General Features
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- ### Best diagnostic clue
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- Posterior pituitary ectopia (PPE): No (or tiny) pituitary stalk, ectopic posterior pituitary (EPP) on midline sagittal T1WI MR
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- Partial pituitary ectopia also reported
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- Duplicated pituitary gland/stalk (DP): 2 pituitary stalks on coronal view, thick tuber cinereum on midline sagittal view
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- Tuberomammillary fusion: Tuber cinereum/mammillary bodies fused into single mass
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- Pituitary hypoplasia: Small sella turcica and adenohypophysis
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- ### Location
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- PPE: EPP located along median eminence of tuber cinereum or truncated pituitary stalk
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- DP: Paired lateral stalks, pituitary glands, bony fossae
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- ### Size
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- PPE: Anterior pituitary (adenohypophysis) is small
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- DP: Each pituitary gland is normal in size
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- ### Morphology
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- PPE: Small adenohypophysis and osseous sella
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- DP: Each pituitary gland and osseous sella is normal in morphology but laterally located
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- ## Radiographic Findings
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- ### Radiography
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- PPE: Small sella turcica on lateral view
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- DP: Craniofacial/craniocervical anomalies common; may observe 2 fossae on AP view
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- ## CT Findings
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- ### NECT
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- PPE: Narrow pituitary fossa and skull base structures and clivus, ± persistent sphenopharyngeal foramen
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- DP: 2 widely separated pituitary fossae, ± midline basisphenoid cleft or frontonasal dysplasia
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- ### CTA
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- PPE: Medial deviation of juxtasellar/supraclinoid carotid arteries ("kissing" carotids)
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- DP: Duplicated basilar artery (BA), ± widely separated juxtasellar/supraclinoid carotid arteries
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- ## MR Findings
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- ### T1WI
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- PPE: Absent, truncated, or thread-like pituitary stalk; small adenohypophysis
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- EPP located along truncated stalk or median eminence of tuber cinereum
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- Usually ↑ signal on T1WI (phospholipids/secretory granules)
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- Posterior pituitary may "dim" as patient outgrows available hormone levels
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- Chiari 1 (20%), ± olfactory hypoplasia, frontal lobe dysgenesis/migration anomalies
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- ± absent septum pellucidum, ocular dysgenesis, hypoplastic optic nerves/chiasm
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- DP: Mass-like thickening of tuber cinereum on sagittal view portends duplicated pituitary axis
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- Mammillary bodies fused with tuber cinereum into thickened 3rd ventricle floor
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- 2 lateralized but otherwise normal pituitary glands/stalks
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- Brain anomalies: Callosal dysgenesis, duplicated anterior 3rd ventricle, cleft brainstem, Dandy-Walker malformation
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- Cranial nerve anomalies: Olfactory nerve and optic nerve hypoplasia
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- Oral tumors: Epignathus (giant teratoma) or dermoid (mixed signal), lipoma (↑ T1WI)
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- ### T2WI
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- PPE: Variable signal of posterior pituitary
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- DP: Normal signal of glands, stalk, tuberomammillary fusion mass
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- ### T1WI C+
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- Both: Stalks and remnants enhance (absent blood-brain barrier)
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- PPE: Hyperintensity absent if multiple endocrine anomalies/diabetes insipidus; contrast enhancement helps find neurohypophysis
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- ### MRA
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- PPE: Supraclinoid carotid arteries medially deviated, "kiss" in midline; rare absent carotid artery/canal
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- DP: Fenestration (common) or total duplication (rare) of BA; widely separated juxtasellar carotid arteries
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- ### MRV
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- Used to characterize torcular and straight sinus anomalies if midline posterior fossa anomaly identified
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- ## Angiographic Findings
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- Conventional
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- PPE: Variable deviation "kissing" carotids (37%)
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- DP: Split/duplicated BA, ± lateral deviation carotids
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- ## Imaging Recommendations
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- ### Best imaging tool
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- Multiplanar T1WI MR
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- ### Protocol advice
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- Both: Sagittal and coronal T1WI ± T2WI of hypothalamic/pituitary axis
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- PPE: Assess olfactory nerves, anterior frontal lobes with coronal T2WI
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- 3D T1WI SPGR can identify small posterior pituitaries, occult on conventional 2D sagittal T1WI
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- DP: 3D CT of skull base and face in selected patients
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# DIFFERENTIAL DIAGNOSIS
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- [Posterior Pituitary Ectopia](/document/pituitary-anomalies/556da02b-74c3-489a-8aed-ebbc97b620fa)
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- **Central diabetes insipidus**
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- Hyperintensity of posterior pituitary lobe is absent but normal location of stalk and gland
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- **Surgical or traumatic stalk transection**
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- Permits build-up of neurosecretory granules along stump
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- [Hypothalamic lipoma (located at tuber cinereum)](/document/lipoma-brain/1bdb974e-8346-4730-9b1c-dea7b70b844d)
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- Posterior pituitary is not suppressed by fat saturation; lipoma is suppressed
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- ## Duplicated Pituitary Gland/Stalk
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- **Dilated infundibular recess of 3rd ventricle ("pseudoduplication")**
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- Simulates duplicated stalk but only 1 gland and 1 pituitary fossa
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- [Tuber cinereum hamartoma](/document/hypothalamic-hamartoma/7f85487f-9497-44a9-b884-b98e50d41018)
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- Round mass of 3rd ventricle floor but 1 midline pituitary stalk/gland
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# PATHOLOGY
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- ## General Features
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- ### Etiology
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- PPE: Genetic mutation → defective neuronal migration during embryogenesis
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- Adenohypophysis (anterior pituitary) grows up from stomodeal ectoderm (Rathke pouch)
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- Hypothalamic-releasing hormones reach adenohypophysis via infundibular portal system
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- Anterior pituitary dysfunction thought to be related to absent infundibulum
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- Neurohypophysis (posterior pituitary) grows down from diencephalic neuroectoderm, remains attached by stalk
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- Antidiuretic hormone and oxytocin transported to neurohypophysis via neurosecretory cells along infundibulum
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- DP: Congenital anomaly, presumed genetic duplication of stomodeal origin structures 2° to aberrant ventral induction
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- Theory: Duplication prechordal plate and tip of rostral notochord leads to duplicated pituitary primordium
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- ### Genetics
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- PPE: Mutations in genes encoding developmental transcription factors allow maldevelopment
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- *HESX1* (homeobox gene), *POU1F1* (PIT1), *PITX2*, *LHX3*, *LHX4*, *PROP1*, *SF1*, and *TBX19* (TPIT)
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- DP: Gene mutation unknown; may constitute polytopic field defect due to splitting of notochord
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- ### Associated abnormalities
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- DP
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- Midline tumors in oral, nasopharyngeal, palate
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- Epignathus, hamartomas, teratomas, dermoids, lipomas
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- Spinal anomalies include segmentation/fusion anomalies, schisms, hydromyelia, enteric cysts
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- Rib and cardiac anomalies, Pierre-Robin anomaly
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- **Both**: Common midline CNS anomalies
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- PPE
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- ± anomalies of structures formed at same time (anterior pituitary lobe, forebrain, eyes, olfactory bulbs)
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- ± lobar holoprosencephaly, septo-optic dysplasia, Joubert syndrome
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- DP
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- Callosal dysgenesis, Dandy-Walker spectrum, frontonasal dysplasia
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- Craniofacial clefting and duplication anomalies: Frontonasal dysplasia; clefts/duplication of skull base, face, mandible, nose, palate
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- Pituitary hypoplasia associated with Kallmann syndrome
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- ## Gross Pathologic & Surgical Features
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- PPE: Hypoplastic anterior lobe, stalk truncation or aplasia
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- Sella may be covered over with dura
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- DP: Tuberomammillary fusion, 2 normal glands/stalks
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- ## Microscopic Features
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- PPE: Ectopic pituitary cells in stalk or sphenoid bone
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- DP: Normal (but duplicated) pituitary glands, tuberomammillary fusion, incompletely migrated hypothalamic nuclear cells
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# CLINICAL ISSUES
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- ## Presentation
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- ### Most common signs/symptoms
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- PPE: Short stature
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- DP: Unsuspected finding on craniofacial imaging for other indications
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- ### Other signs/symptoms
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- PPE: Multiple pituitary hormone deficiencies common
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- DP: Rarely symptomatic from pituitary causes
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- ### Clinical profile
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- PPE: Short stature (growth hormone deficiency), ± multiple endocrine deficiencies
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- Peak growth hormone levels < 3 g/L more likely to have abnormal MR
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- ± anosmia, poor vision, seizures (cortical malformations)
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- Neonatal hypoglycemia or jaundice, micropenis, single central incisor
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- DP: ± facial midline anomalies, oral or nasal mass (hamartoma or teratoma)
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- Face: ± hypertelorism or frontonasal dysplasia
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- Craniocervical segmentation and fusion anomalies
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- Airway or oral obstruction from pharyngeal tumor
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- ## Demographics
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- ### Age
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- PPE: Early growth failure apparent in childhood
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- DP: Usually discovered in early infancy during imaging for complicated facial anomalies
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- ### Sex
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- PPE: M > F
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- DP: M < F
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- ### Ethnicity
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- None identified in either diagnosis
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- ### Epidemiology
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- PPE: Prevalence 1:4,000 to 1:20,000 births
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- DP: Extremely rare (reported in 20+ cases)
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- ## Natural History & Prognosis
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- PPE: Stable if no pituitary/hypothalamic crises; growth may be normal for a while
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- Severity and number of hormone deficiencies predicted by degree of stalk and gland hypoplasia
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- DP: Usually significant intracranial, upper airway, or craniocervical malformations (some lethal)
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- Clinical outcome unrelated to pituitary function
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- ## Treatment
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- Assess/treat endocrine malfunction
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# DIAGNOSTIC CHECKLIST
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- ## Consider
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- PPE: Assess optic and olfactory nerves, frontal cortex
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- DP: Oral tumors compromise airway patency
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- ## Image Interpretation Pearls
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- PPE/DP: Can miss findings/diagnosis if thick sections (MR) are used or osseous structures (bone CT) not evaluated
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53d837b5-0d4f-4b57-9fec-ab55d208fe21
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## References
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# Selected References
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1. [Ybarra M et al: A new imaging entity consistent with partial ectopic posterior pituitary gland: report of six cases. Pediatr Radiol. 50(1):107-15, 2020](http://www.ncbi.nlm.nih.gov/pubmed/?term=31468085%5Bpmid%5D)
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1. [Ruszała A et al: Distinguishing between post-trauma pituitary stalk disruption and genetic pituitary stalk interruption syndrome - case presentation and literature overview. Pediatr Endocrinol Diabetes Metab. 25(3):155-62, 2019](http://www.ncbi.nlm.nih.gov/pubmed/?term=31769274%5Bpmid%5D)
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1. [Dumrongpisutikul N et al: Pituitary height at magnetic resonance imaging in pediatric isolated growth hormone deficiency. Pediatr Radiol. 48(5):694-700, 2018](http://www.ncbi.nlm.nih.gov/pubmed/?term=29508041%5Bpmid%5D)
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1. [Godano E et al: Role of MRI T2-DRIVE in the assessment of pituitary stalk abnormalities without gadolinium in pituitary diseases. Eur J Endocrinol. 178(6):613-22, 2018](http://www.ncbi.nlm.nih.gov/pubmed/?term=29650689%5Bpmid%5D)
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1. [El Sanharawi I et al: High-resolution heavily T2-weighted magnetic resonance imaging for evaluation of the pituitary stalk in children with ectopic neurohypophysis. Pediatr Radiol. 47(5):599-605, 2017](http://www.ncbi.nlm.nih.gov/pubmed/?term=28255689%5Bpmid%5D)
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1. [Asakura Y et al: Combined pituitary hormone deficiency with unique pituitary dysplasia and morning glory syndrome related to a heterozygous PROKR2 mutation. Clin Pediatr Endocrinol. 24(1):27-32, 2015](http://www.ncbi.nlm.nih.gov/pubmed/?term=25678757%5Bpmid%5D)
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1. [Kilday JP et al: Diabetes insipidus in pediatric germinomas of the suprasellar region: characteristic features and significance of the pituitary bright spot. J Neurooncol. 121(1):167-75, 2015](http://www.ncbi.nlm.nih.gov/pubmed/?term=25266413%5Bpmid%5D)
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1. [Ören NC et al: Panhypopituitarism with ectopic posterior pituitary lobe, heterotopia, polymicrogyria, corpus callosum dysgenesis, and optic chiasm/nerve hypoplasia: is that an undefined neuronal migration syndrome? AJNR Am J Neuroradiol. 36(5):E33-5, 2015](http://www.ncbi.nlm.nih.gov/pubmed/?term=25721080%5Bpmid%5D)
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1. [Ramakrishnaiah RH et al: Reliability of magnetic resonance imaging for the detection of hypopituitarism in children with optic nerve hypoplasia. Ophthalmology. 121(1):387-91, 2014](http://www.ncbi.nlm.nih.gov/pubmed/?term=23972277%5Bpmid%5D)
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1. [Ginat DT et al: Nasal hamartoma associated with duplicated pituitary. J Comput Assist Tomogr. 37(3):369-70, 2013](http://www.ncbi.nlm.nih.gov/pubmed/?term=23674006%5Bpmid%5D)
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1. [Maeda Y et al: Clinical presentation of epignathus teratoma with cleft palate; and duplication of cranial base, tongue, mandible, and pituitary gland. J Craniofac Surg. 24(4):1486-91, 2013](http://www.ncbi.nlm.nih.gov/pubmed/?term=23851840%5Bpmid%5D)
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1. [Manjila S et al: Duplication of the pituitary gland associated with multiple blastogenesis defects: duplication of the pituitary gland (DPG)-plus syndrome. Case report and review of literature. Surg Neurol Int. 3:23, 2012](http://www.ncbi.nlm.nih.gov/pubmed/?term=22439114%5Bpmid%5D)
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1. [Usta Y et al: Duplicated pituitary gland and odontoid process. A case report. Neuroradiol J. 25(3):360-3, 2012](http://www.ncbi.nlm.nih.gov/pubmed/?term=24028990%5Bpmid%5D)
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1. [Kriström B et al: A novel mutation in the LHX3 gene is responsible for combined pituitary hormone deficiency, hearing impairment, and vertebral malformations. J Clin Endocrinol Metab. 6, 2009](http://www.ncbi.nlm.nih.gov/pubmed/?term=19126629%5Bpmid%5D)
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1. [Tajima T et al: OTX2 loss of function mutation causes anophthalmia and combined pituitary hormone deficiency with a small anterior and ectopic posterior pituitary. J Clin Endocrinol Metab. 94(1):314-9, 2009](http://www.ncbi.nlm.nih.gov/pubmed/?term=18854396%5Bpmid%5D)
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1. [Kelberman D et al: SOX2 plays a critical role in the pituitary, forebrain, and eye during human embryonic development. J Clin Endocrinol Metab. 93(5):1865-73, 2008](http://www.ncbi.nlm.nih.gov/pubmed/?term=18285410%5Bpmid%5D)
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1. [Loddenkemper T et al: Pituitary stalk duplication in association with moya moya disease and bilateral morning glory disc anomaly - broadening the clinical spectrum of midline defects. J Neurol. 255(6):885-90, 2008](http://www.ncbi.nlm.nih.gov/pubmed/?term=18350354%5Bpmid%5D)
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1. [Vieira TC et al: Central precocious puberty associated with pituitary duplication and midline defects. J Pediatr Endocrinol Metab. 20(10):1141-4, 2007](http://www.ncbi.nlm.nih.gov/pubmed/?term=18051933%5Bpmid%5D)
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1. [Huisman TA et al: Pituitary duplication and nasopharyngeal teratoma in a newborn: CT, MRI, US and correlative histopathological findings. Neuroradiology. 47(7):558-61, 2005](http://www.ncbi.nlm.nih.gov/pubmed/?term=15942796%5Bpmid%5D)
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1. [Slavotinek A et al: Craniofacial defects of blastogenesis: duplication of pituitary with cleft palate and orophgaryngeal tumors. Am J Med Genet A. 135(1):13-20, 2005](http://www.ncbi.nlm.nih.gov/pubmed/?term=15810008%5Bpmid%5D)
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1. [Shroff M et al: Basilar artery duplication associated with pituitary duplication: a new finding. AJNR Am J Neuroradiol. 24(5):956-61, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=12748101%5Bpmid%5D)
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1. [Cushman LJ et al: Genetic defects in the development and function of the anterior pituitary gland. Ann Med. 34(3):179-91, 2002](http://www.ncbi.nlm.nih.gov/pubmed/?term=12173688%5Bpmid%5D)
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1. [Uchino A et al: Extreme fenestration of the basilar artery associated with cleft palate, nasopharyngeal mature teratoma, and hypophyseal duplication. Eur Radiol. 12(8):2087-90, 2002](http://www.ncbi.nlm.nih.gov/pubmed/?term=12136328%5Bpmid%5D)
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1. [Burke M et al: Duplication of the hypophysis. Pediatr Neurosurg. 33(2):95-9, 2000](http://www.ncbi.nlm.nih.gov/pubmed/?term=11070436%5Bpmid%5D)
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1. [Hamilton J et al: MR imaging in idiopathic growth hormone deficiency. AJNR Am J Neuroradiol. 19(9):1609-15, 1998](http://www.ncbi.nlm.nih.gov/pubmed/?term=9802480%5Bpmid%5D)
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1. [Hamon-Kérautret M et al: Duplication of the pituitary gland in a newborn with median cleft face syndrome and nasal teratoma. Pediatr Radiol. 28(5):290-2, 1998](http://www.ncbi.nlm.nih.gov/pubmed/?term=9569260%5Bpmid%5D)
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1. [Kollias SS et al: Review of the embryologic development of the pituitary gland and report of a case of hypophyseal duplication detected by MRI. Neuroradiology. 37(1):3-12, 1995](http://www.ncbi.nlm.nih.gov/pubmed/?term=7708185%5Bpmid%5D)
|
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1. [Ryals BD et al: Duplication of the pituitary gland as shown by MR. AJNR Am J Neuroradiol. 14(1):137-9, 1993](http://www.ncbi.nlm.nih.gov/pubmed/?term=8427075%5Bpmid%5D)
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## Images
|
||||
|
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### Selected Images
|
||||
|
||||
|
||||
*Sagittal graphic shows ectopia of the posterior pituitary gland <img src='img/arrows/WS.png'/> located at the distal end of a truncated pituitary stalk along the median eminence of the hypothalamus. The sella turcica and adenohypophysis <img src='img/arrows/WC.png'/> are both small.*
|
||||
|
||||
|
||||
*Sagittal graphic shows ectopia of the posterior pituitary gland <img src='img/arrows/WS.png'/> located at the distal end of a truncated pituitary stalk along the median eminence of the hypothalamus. The sella turcica and adenohypophysis <img src='img/arrows/WC.png'/> are both small.*
|
||||
|
||||
|
||||
*Sagittal T1 MR shows an ectopic posterior pituitary gland in a 17-year-old girl with short stature. The T1-hyperintense posterior gland is at the median eminence <img src='img/arrows/CO.png'/> instead of its normal position. The pituitary infundibulum is absent and the anterior pituitary gland <img src='img/arrows/WC.png'/> is small.*
|
||||
|
||||
|
||||
*Sagittal T1 MR shows an ectopic posterior pituitary gland in a 17-year-old girl with short stature. The T1-hyperintense posterior gland is at the median eminence <img src='img/arrows/CO.png'/> instead of its normal position. The pituitary infundibulum is absent and the anterior pituitary gland <img src='img/arrows/WC.png'/> is small.*
|
||||
|
||||
|
||||
*Coronal T1 MR depicts the ectopic posterior pituitary gland location at the median eminence <img src='img/arrows/CO.png'/> of the hypothalamus. A pituitary stalk is not visualized below the ectopic posterior pituitary. The septum pellucidum is present, and the optic tracts <img src='img/arrows/WC.png'/> are of normal size.*
|
||||
|
||||
|
||||
*Coronal T1 MR depicts the ectopic posterior pituitary gland location at the median eminence <img src='img/arrows/CO.png'/> of the hypothalamus. A pituitary stalk is not visualized below the ectopic posterior pituitary. The septum pellucidum is present, and the optic tracts <img src='img/arrows/WC.png'/> are of normal size.*
|
||||
|
||||
|
||||
*Sagittal T2 MR in a patient with complete absence of the posterior pituitary bright spot shows a small sella turcica and pituitary gland <img src='img/arrows/WO.png'/>. The optic apparatus <img src='img/arrows/WS.png'/> is also hypoplastic. A clearly defined pituitary stalk <img src='img/arrows/BS.png'/> is present.*
|
||||
|
||||
|
||||
*Sagittal T2 MR in a patient with complete absence of the posterior pituitary bright spot shows a small sella turcica and pituitary gland <img src='img/arrows/WO.png'/>. The optic apparatus <img src='img/arrows/WS.png'/> is also hypoplastic. A clearly defined pituitary stalk <img src='img/arrows/BS.png'/> is present.*
|
||||
|
||||
|
||||
*Sagittal T1 MR shows a small pituitary gland <img src='img/arrows/BS.png'/> and absent pituitary stalk. The hyperintense ectopic posterior pituitary gland <img src='img/arrows/CO.png'/> is located at the median eminence. The corpus callosum is also dysmorphic with characteristic small splenium <img src='img/arrows/WS.png'/>.*
|
||||
|
||||
|
||||
*Sagittal T1 MR shows a small pituitary gland <img src='img/arrows/BS.png'/> and absent pituitary stalk. The hyperintense ectopic posterior pituitary gland <img src='img/arrows/CO.png'/> is located at the median eminence. The corpus callosum is also dysmorphic with characteristic small splenium <img src='img/arrows/WS.png'/>.*
|
||||
|
||||
|
||||
*Coronal T2 MR in the same patient demonstrates associated left periventricular nodular gray matter heterotopia <img src='img/arrows/CS.png'/> and dysplastic inferior temporal lobe gray matter. Right choroid fissure cyst <img src='img/arrows/WC.png'/> is probably unrelated.*
|
||||
|
||||
|
||||
*Coronal T2 MR in the same patient demonstrates associated left periventricular nodular gray matter heterotopia <img src='img/arrows/CS.png'/> and dysplastic inferior temporal lobe gray matter. Right choroid fissure cyst <img src='img/arrows/WC.png'/> is probably unrelated.*
|
||||
|
||||
|
||||
*Sagittal T1 MR demonstrates a bright ectopic posterior pituitary gland <img src='img/arrows/WS.png'/> in a patient with septo-optic dysplasia. Note the small optic chiasm <img src='img/arrows/WO.png'/> and the low location of the fornices <img src='img/arrows/WC.png'/>.*
|
||||
|
||||
|
||||
*Sagittal T1 MR demonstrates a bright ectopic posterior pituitary gland <img src='img/arrows/WS.png'/> in a patient with septo-optic dysplasia. Note the small optic chiasm <img src='img/arrows/WO.png'/> and the low location of the fornices <img src='img/arrows/WC.png'/>.*
|
||||
|
||||
|
||||
*Sagittal T1 MR in a patient with duplicated pituitary glands shows a thickened floor of sella and fusion of the tuber cinereum and mammillary bodies (tuberomammillary fusion) <img src='img/arrows/WS.png'/>. Note the absence of a midline sella turcica and pituitary infundibulum.*
|
||||
|
||||
|
||||
*Sagittal T1 MR in a patient with duplicated pituitary glands shows a thickened floor of sella and fusion of the tuber cinereum and mammillary bodies (tuberomammillary fusion) <img src='img/arrows/WS.png'/>. Note the absence of a midline sella turcica and pituitary infundibulum.*
|
||||
|
||||
|
||||
*Coronal T2 MR in a newborn with midline skull base clefting reveals 2 pituitary stalks <img src='img/arrows/BS.png'/>. The normal-sized pituitary stalks project below the optic chiasm toward duplicated pituitary glands.*
|
||||
|
||||
|
||||
*Coronal T2 MR in a newborn with midline skull base clefting reveals 2 pituitary stalks <img src='img/arrows/BS.png'/>. The normal-sized pituitary stalks project below the optic chiasm toward duplicated pituitary glands.*
|
||||
|
||||
|
||||
*Coronal T1 MR demonstrates 2 normal-sized pituitary glands <img src='img/arrows/WS.png'/> laterally displaced within the abnormal skull base. The glands are uniformly hyperintense due to maternal hormonal influences. The pituitary gland is normally diffusely hyperintense on T1 MR in newborns.*
|
||||
|
||||
|
||||
### Additional Images
|
||||
|
||||
|
||||
*Sagittal T1WI MR reveals a small anterior pituitary gland and ectopic posterior pituitary bright spot <img src='img/arrows/WS.png'/> located along tuber cinereum. Pituitary stalk is absent in this 2 year old with growth failure.*
|
||||
|
||||
|
||||
*Coronal MRA in a patient with ectopic posterior pituitary bright spot shows marked medial deviation of the juxtasellar/supraclinoid internal carotid arteries. Note right deviated internal carotid artery <img src='img/arrows/BC.png'/> and dominant left anterior cerebral artery (ACA).*
|
||||
|
||||
|
||||
*Coronal MRA in an infant with pituitary duplication demonstrates partial duplication of the upper basilar artery. Note that each superior cerebellar artery <img src='img/arrows/BS.png'/> arises from its "own" basilar artery.*
|
||||
|
||||
|
||||
*Coronal T1WI MR depicts the ectopic posterior pituitary gland location at the median eminence <img src='img/arrows/WS.png'/>. A pituitary stalk is not visualized below the ectopic posterior pituitary. The septum pellucidum is present, and the optic tracts <img src='img/arrows/WC.png'/> are of normal size.*
|
||||
|
||||
|
||||
*Axial T1WI C+ MR confirms the ectopic position of the bright posterior pituitary gland <img src='img/arrows/WS.png'/> at the median eminence in the expected location of the infundibular stalk base.*
|
||||
|
||||
Reference in New Issue
Block a user