Application of phase sensitive imaging (PSI) for hemorrhage diagnosis in pituitary adenomas

Abstract

Objective: Intratumoral hemorrhaging is a common occurrence in pituitary adenomas. Asymptomatic pituitary apoplexies have become more frequently diagnosed due to recent advances in magnetic resonance (MR) imaging. The purpose of this study was to investigate the usefulness of phase sensitive imaging (PSI) in the diagnosis of hemorrhages within pituitary adenomas.Patients and methods: PSI methodology was applied to 28 patients with surgically diagnosed pituitary macroadenomas, and compared with conventional methods. No patients presented with sudden onset of apoplectic symptoms. A 3·0 T MR unit was used to examine all patients before surgery.Results: Seventeen of 28 cases exhibited a hemorrhage component on PSI. However, hemorrhaging was demonstrated in 13 of 28 cases by T2-weighted imaging (T2WI). Hemorrhaging was detected in pituitary adenomas by PSI, but not by T2WI, in four of 17 cases. Poor visualization of the hemorrhage in the sellar turcica was a drawback, which was due to PSI artifacts.Conclusion: We suggest that PSI be used to provide diagnostic assistance for pituitary apoplexies.