AI Article Synopsis
- The study aims to investigate the shape of the sella and the height of the pituitary gland in patients with Chiari II malformation (C2M) using brain MRI, potentially explaining the high incidence of apparent pituitary enlargement.
- The research involved reviewing brain MRIs of C2M patients and comparing their sella and pituitary measurements with those of control groups with normal MRIs and chronic ventricular shunts.
- Results showed C2M patients had significantly smaller dorsum sella and larger pituitary glands, but the findings indicated no underlying pituitary pathology, suggesting that the sella’s shape could influence perceived pituitary size, highlighting the need for careful evaluation to prevent unnecessary treatments.
Article Abstract
Purpose: To systematically evaluate the sella morphology and pituitary gland height on brain MRI of Chiari II malformation (C2M) patients to understand the observed high incidence of apparent enlargement of the pituitary gland.
Methods: Brain MRIs of C2M patients at a single tertiary care adult institution were retrospectively reviewed. We also evaluated two age and gender-matched control groups-patients with normal brain MRI (C1 group) and chronic ventricular shunts (C2 group). The heights of tuberculum sella, dorsum sella, and pituitary gland were measured and compared. The presence or absence of dural thickening was noted.
Results: 21 patients were included in each group. In C2M group, a pituitary adenoma was suggested on 24% of the MRIs. The dorsum sella was significantly smaller in the C2M group (4.8 mm) compared to both the C1 group (7.4 mm, p < 0.001) and the C2 group (7.1 mm, p < 0.001). The pituitary gland was also larger in the cranial-caudal dimension in C2M group (8.6 mm) as compared to both the C1 group (6.6 mm, p < 0.01) and the C2 group (6.0 mm, p < 0.001). One C2M patient with a pituitary gland<10 mm was suggested to have a pituitary adenoma on outside MRI, although a normal pituitary gland was seen on pathology.
Conclusion: C2M patients have shallow sella which can accentuate the pituitary gland height. The mean pituitary height was larger in C2M patients, but no functional pituitary pathology was present. It is important to consider sella morphology when evaluating the pituitary gland of C2M patients to avoid unnecessary medical and surgical interventions.
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| http://dx.doi.org/10.1016/j.clinimag.2020.02.014 | DOI Listing |
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