RadteraMRI Pituitary / Sella With and Without Contrast
MR+ ContrastNeuro
Indications
- Suspected pituitary adenoma (micro/macro)
- Hyperprolactinemia / endocrine abnormality
- Cushing/acromegaly work-up
- Visual field defect / bitemporal hemianopia
- Diabetes insipidus
- Sellar/parasellar mass
Patient prep
- MRI safety screening
- IV access for contrast
- Head coil
Contrast
Agentgadolinium-based
RouteIV
Dose0.1 mmol/kg
TimingDynamic coronal post-contrast for microadenoma; then standard post-contrast
Technique
- Small FOV (~16-18 cm) targeted to sella
- Thin coronal and sagittal slices (2-3 mm) through pituitary
- Dynamic contrast (coronal thin T1 repeated over time) increases microadenoma detection (adenomas enhance more slowly than normal gland)
- Whole-brain screening optional depending on site
Series / Sequences
| # | Series / Sequence | Plane | Weighting / Recon | Thickness | Notes |
|---|---|---|---|---|---|
| 1 | Sag T1 sella | sagittal | T1 | 2-3 mm | Posterior pituitary bright spot, stalk |
| 2 | Cor T1 sella pre | coronal | T1 | 2-3 mm | |
| 3 | Cor T2 sella | coronal | T2 | 2-3 mm | Cystic/optic chiasm relationship |
| 4 | Cor dynamic T1 post | coronal | T1 +C dynamic | 2-3 mm | Repeated acquisitions during early enhancement |
| 5 | Cor T1 post | coronal | T1 +C | 2-3 mm | |
| 6 | Sag T1 post | sagittal | T1 +C | 2-3 mm |
Key points
- Dynamic imaging key for microadenoma (slow-enhancing focus vs avidly enhancing normal gland).
- Assess optic chiasm, cavernous sinus invasion (Knosp), and stalk.
- Macroadenoma: include whole-sella and suprasellar extension.
- Loss of posterior pituitary bright spot suggests central DI.
References
• ACR-ASNR Practice Parameter for MRI of the Head
• Radiopaedia: Pituitary MRI protocol link
• RadioGraphics: Imaging of the sellar region
• Radiopaedia: Pituitary MRI protocol link
• RadioGraphics: Imaging of the sellar region
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.