Magnetic resonance imaging in pituitary apoplexy

D. Lacomis, L. N. Johnson and A. C. Mamourian
Neuro-Ophthalmology Unit, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.

The diagnosis of pituitary apoplexy, an often-fatal disorder, is frequently delayed. Computed tomographic (CT) scanning has been shown to be useful in the detection of pituitary apoplexy; however, the value of magnetic resonance imaging (MRI) is yet to be determined. The MRI and CT scans of three consecutive and histopathologically proved cases of pituitary apoplexy were reviewed. The MRI scans obtained at least five days after the onset of symptoms suggested pituitary apoplexy (hemorrhage) in all three cases, while CT scanning indicated pituitary hemorrhage in only one case. Increased signal on the T1-weighted image was the hallmark on MRI scans in all three cases. These findings suggest that MRI scanning may be superior to CT scanning in identifying pituitary apoplexy, at least in the subacute phase.