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Forum Name: Neurology Topics

Question: Will pituitary MRI show all parts of brain?


 Vespy - Sun Jul 25, 2010 11:04 pm

I just had an MRI done on my pituitary gland and the orbits(?) of my eyes. I'm concerned about other symptoms I am having and am debating whether to call my neurologist to schedule a MRI of the entire brain - specifically, I'm concerned about the brain stem - but would such action be redundant, with most or all of the brain visible from the pituitary MRI?

Thank you.
 Dr.M.Aroon kamath - Sat Aug 21, 2010 3:27 am

User avatar Hi,
Magnetic resonance imaging (MRI) is the modality of choice in the investigation of pituitary tumors. Based on the clinical circumstances, the protocols needed may vary. For example,
- may be requested with a localized pituitary protocol(sella protocol),
- may be a sella and juxta sellar protocol,
- with the dynamic protocol,or
- a fat suppression MRI protocol(Eliminating fat signal by fat-suppression techniques can increase the yield of contrast-enhanced MRI).
A small field of view is frequently used in pituitary protocols.

On dynamic MRI, a contrast agent is infused continuously during the scanning. Pitutary adenomas generally enhance slower than the normal areas of the pitutary gland (areas of "hypointensity").

Juxta sellar protocol is intended to detect sellar or parasellar lesions [intrusion into surrounding structures (optic chiasma, sphenoid sinus, cavernous sinus, anterior brainstem,frontal and temporal lobes), and to detect any abnormality of the nasal cavities which may preclude a trans-sphenoidal surgical approach].

What is important to realize, is that many of these protocols were designed and developed with the primary intention of identifying smaller (microadenomas- < 10mm) of the pituitary. Thus, the MRI of the pituitary gland is not to be relied upon to comment about the rest of the brain, which needs a different protocol.
Best wishes!

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