Keywords:
Neuroradiology brain, Neuroradiology peripheral nerve, Neuroradiology spine
Authors:
A. J. B. Baxi, M. belman, T. Nagendra, S. Vidyasagar, K. L. Tourani; Hyderabad/IN
DOI:
10.1594/ecr2010/C-2713
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 has implications for correct histopathologic diagnosis and treatment.
Inflammatory disorders are likely underrecognized as a cause of masses of the hypothalamus in adults. Their inclusion in the differential diagnosis of adult hypothalamus disease is important because it may allow the option for noninvasive treatment and improved clinical course, particularly in patients with INH or adenohypophysitis.
MR imaging is an excellent noninvasive modality for evaluation of the hypothalamus and pituitary gland. It not only depicts anatomy of pituitary gland, infundibulum, optic chiasm, cavernous sinuses, and neighboring vascular structures but also helps in identifying there pathologies and thus aids in differential diagnosis.
The addition of gadolinium further facilitates diagnosis and increases the confidence level especially when concerned regarding invasion of adjacent structures and cavernous sinus. Visualization of vascular parasellar structures such as intrasellar carotid artery loop or aneurysm is also clearly seen, which is crucial in some cases.
The specific bony landmarks are sometimes difficult to demonstrate on MRI, but T2 Fat saturated sequence coupled with contrast study, gives sufficient information. However, CT scanning still holds the edge in evaluating bony abnormalities.