Purpose
Hypothalamus, the ventral-most portion of the diencephaIon,surrounds theanterior inferior portion of the third ventricle(Fig. 1 & 2).It functions primarily as an integrative mechanism for various autonomic and neuroendocrine activities including temperature regulation, water balance, behavior and appetite.There is variability concerning the appearance of hypothalamic lesions The hypothalamus is susceptible to involvement by a variety of processes, including developmental abnormalities, primary tumors of the central nervous system (CNS), vascular tumors, systemic tumors affecting the CNS, inflammatory and granulomatous disease. The hypothalamus may also be involved by...
Methods and Materials
A retrospective review of our institutional case archive from 2002 to2009 revealed broad range of neoplasms, inflammatory and infectious disorders, and congenital and developmental lesions. The region of study included hypothalamus, pituitary glandand parasellar region.Imagingwere performed on 1.5 Tesla MRI with head coil, single slice CT, 6 slice CT and 64 slice CT scanner to characterize the pathologic spectrum of hypothalamic and parahypothalamic diseases with soft tissue and bony reconstruction whenever needed.Sagittal and coronal spin-echo T1-weighted sequences were performed with thin sections (3mm) and a...
Results
We were able to recognize the clinical manifestations and key MR imaging features of various hypothalamic lesions.We came across developmental abnormalities (craniopharyngioma,hamartoma, dermoid and epidermoid cysts, Rathke cleft cyst[RCC], colloid cyst, primary tumors of the central nervous system (CNS) (hypothalamic-chiasmatic glioma, Pituitary adenoma), systemic tumors affecting CNS, inflammatory and granulomatous diseases (lymphocytic hypophysitis) and lesions arising from surrounding structures.Of the total number of patient studied during 2003-2009, 127 patients had hypothalamic and juxtasellar lesions between the age of 4 -75years .Of this, we excluded 20...
Conclusion
Knowledge of the imaging appearance of diseases specific to pituitary and hypothalamus is important for accurate diagnosis and treatment .The spectrum of pathology involving the hypothalamus is broad yet distinct from other pathology in the sella and parasellar region. The hypothalamus presents a diagnostic imaging challenge because of its small size and protea spectrum of disease processes.Congenital and developmental abnormalities usually have characteristic findings on imaging. Primary glial tumors have distinct different clinical course; therefore, including such tumors in the differential diagnosis of hypothalamus masses...
References
Gray H. Anatomy of the human body. Philadelphia, Pa: Lea & Febiger, 1918; Bartleby.com, 2000. MR Anatomy and Pathology of the Hypothalamus. D.J. Loes, Thomas J. Barloon, William T.C.Yuh, Robert L.,1991 Lesions of the Hypothalamus: MR Imaging Diagnostic Features Sahar N. Saleem, MD, P hD et al RadioGraphics 2007; 27:1087–1108, 2007 Neuroendocrine ImagingD. David J. Seidenwurm, MD,Principal Author, Radiologic Associates of Sacramento,Sacramento,AJNR 29:613–15 :Mar 2008.Diagnostic Neuroradiology: Anne G Osborn,MD.Imaging of PediatricPituitary Abnormalities:Bradley N. Delman, MD.Diagnostic Imaging:Head and Neck, Harnsberger MD. et al,ISBN,2006-2007.Diagnostic Imaging -Brain,Osborn MD,et...
Personal Information
Dr.Belman Murali MD, Cosultant Radiologist,Institute of Radiology and Imaging Sciences (IRIS) Care Hospitals, Road number 1, Banjara Hills,Hyderabad 500033 Andhra Pradesh India. Email:
[email protected]