Hypopituitarism MRI

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Hypopituitarism Microchapters


Patient Information


Historical Perspective




Differentiating Hypopituitarism from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


History and Symptoms

Physical Examination

Laboratory Findings


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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2] Iqra Qamar M.D.[3]


MRI is the imaging procedure of choice in the diagnosis of hypopituitarism. It is preferred over the CT scan as optic chiasm, pituitary stalk, and cavernous sinuses can be seen in MRI. An MRI lesion needs to be related to clinical and lab findings. The absence of an MRI lesion mostly indicates a non-organic etiology. Cystic lesions, such as Rathke's cleft cysts may have a low-intensity signal on T1-weighted images and a high-intensity signal on T2-weighted images. Meningiomas have a homogenous postcontrast enhancement than pituitary adenomas and have a suprasellar attachment. Hemorrhage into the pituitary gland results in a high-intensity signal on both T1- and T2-weighted images.


  • Cystic lesions, such as Rathke's cleft cysts may have
    • A low-intensity signal on T1-weighted images
    • A high-intensity signal on T2-weighted images
Empty Sella. Source: Wikimedia Commons[8]

MRI showing necrotic pituitary adenoma (Source: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 17664)



  1. Vance, Mary Lee (1994). "Hypopituitarism". New England Journal of Medicine. 330 (23): 1651–1662. doi:10.1056/NEJM199406093302306. ISSN 0028-4793.
  2. Li G, Shao P, Sun X, Wang Q, Zhang L (2010). "Magnetic resonance imaging and pituitary function in children with panhypopituitarism". Horm Res Paediatr. 73 (3): 205–9. doi:10.1159/000284363. PMID 20197674.
  3. Child CJ, Zimmermann AG, Woodmansee WW, Green DM, Li JJ, Jung H, Erfurth EM, Robison LL (2011). "Assessment of primary cancers in GH-treated adult hypopituitary patients: an analysis from the Hypopituitary Control and Complications Study". Eur. J. Endocrinol. 165 (2): 217–23. doi:10.1530/EJE-11-0286. PMC 3132593. PMID 21646285.
  4. Pozzi Mucelli, R. S.; Frezza, F.; Magnaldi, S.; Proto, G. (1992). "Magnetic resonance imaging in patients with panhypopituitarism". European Radiology. 2 (1): 42–46. doi:10.1007/BF00714180. ISSN 0938-7994.
  5. Imashuku S, Kudo N, Kaneda S, Kuroda H, Shiwa T, Hiraiwa T, Inagaki A, Morimoto A (2011). "Treatment of patients with hypothalamic-pituitary lesions as adult-onset Langerhans cell histiocytosis". Int. J. Hematol. 94 (6): 556–60. doi:10.1007/s12185-011-0955-z. PMID 22015494.
  6. De Herder WW, Lamberts SW (1995). "Imaging of pituitary tumours". Baillieres Clin. Endocrinol. Metab. 9 (2): 367–89. PMID 7625990.
  7. Taylor SL, Barakos JA, Harsh GR, Wilson CB (1992). "Magnetic resonance imaging of tuberculum sellae meningiomas: preventing preoperative misdiagnosis as pituitary macroadenoma". Neurosurgery. 31 (4): 621–7, discussion 627. PMID 1407446.
  8. "File:Empty Sella MRT FLAIR sag 001.jpg - Wikimedia Commons". Text "Hellerhoff " ignored (help)
  9. 9.0 9.1 Case contributed by Radswiki Radiopaedia(original file ‘’here’’).Creative Commons BY-SA-NC

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