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Magnetic resonance imaging of sellar and juxtasellar abnormalities in the paediatric population: an imaging review.

Shields R, Mangla R, Almast J, Meyers S - Insights Imaging (2015)

Bottom Line: The sellar and juxtasellar regions in the paediatric population are complex both anatomically and pathologically, with magnetic resonance imaging (MRI) being the "gold standard" imaging modality due to the high contrast of detail.Assessment requires a detailed understanding of the anatomy, embryology, pathophysiology and normal signal characteristics of the pituitary gland and surrounding structures in order to appropriately characterise abnormalities.This article aims to provide an overview of the imaging characteristics of developmental/congenital and acquired disease processes which affect the sellar and juxtasellar region in the paediatric population.

View Article: PubMed Central - PubMed

Affiliation: Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, 14642-0001, USA, rachel_shields@urmc.rochester.edu.

ABSTRACT
The sellar and juxtasellar regions in the paediatric population are complex both anatomically and pathologically, with magnetic resonance imaging (MRI) being the "gold standard" imaging modality due to the high contrast of detail. Assessment requires a detailed understanding of the anatomy, embryology, pathophysiology and normal signal characteristics of the pituitary gland and surrounding structures in order to appropriately characterise abnormalities. This article aims to provide an overview of the imaging characteristics of developmental/congenital and acquired disease processes which affect the sellar and juxtasellar region in the paediatric population. Main Messages • The sellar region is anatomically complex and covers a wide pathology spectrum. • MRI is the key imaging modality to assess sellar and juxtasellar pathology. • Numerous developmental anomalies may not be discovered until adulthood. • Knowledge of pathology alerts and guides the clinician towards appropriate management.

No MeSH data available.


Related in: MedlinePlus

Teratoma. Sagittal T1WI (a) and axial T2WI (b) show a lesion at the undersurface of the hypothalamus which has mixed low, intermediate and high signal. Axial CT image (c) shows the lesion to contain zones of calcification, fat and intermediate soft-tissue attenuation
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Fig24: Teratoma. Sagittal T1WI (a) and axial T2WI (b) show a lesion at the undersurface of the hypothalamus which has mixed low, intermediate and high signal. Axial CT image (c) shows the lesion to contain zones of calcification, fat and intermediate soft-tissue attenuation

Mentions: Extra-gonadal germ cell tumours include: germinoma (most common), mature teratoma, malignant teratoma, yolk sac tumour, embryonal carcinoma and choriocarcinoma. They account for 0.6 % of primary intracranial tumours, with an incidence of 0.09 per 100,000. Peak incidence occurs between 10 and 14 years, with 90 % occurring in patients less than 25 years. They occur more frequently in males. Prognosis depends on the histological subtype, with a 10 year survival rate for germinomas of over 85 %. Other germ cell tumours have a lower survival rate, particularly those containing non-germinomatous malignant cells. Tumours often have intermediate signal on T1WI, slightly high signal on T2WI, and show contrast enhancement. They are typically centred on the pituitary stalk with the posterior pituitary bright spot often absent. They may look similar to Langerhans’ cell histiocytosis (LCH) or lymphocytic hypophysitis [53]. Contrast-enhancing disseminated subarachnoid and/or intraventricular tumour may occur through CSF seeding.


Magnetic resonance imaging of sellar and juxtasellar abnormalities in the paediatric population: an imaging review.

Shields R, Mangla R, Almast J, Meyers S - Insights Imaging (2015)

Teratoma. Sagittal T1WI (a) and axial T2WI (b) show a lesion at the undersurface of the hypothalamus which has mixed low, intermediate and high signal. Axial CT image (c) shows the lesion to contain zones of calcification, fat and intermediate soft-tissue attenuation
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4376809&req=5

Fig24: Teratoma. Sagittal T1WI (a) and axial T2WI (b) show a lesion at the undersurface of the hypothalamus which has mixed low, intermediate and high signal. Axial CT image (c) shows the lesion to contain zones of calcification, fat and intermediate soft-tissue attenuation
Mentions: Extra-gonadal germ cell tumours include: germinoma (most common), mature teratoma, malignant teratoma, yolk sac tumour, embryonal carcinoma and choriocarcinoma. They account for 0.6 % of primary intracranial tumours, with an incidence of 0.09 per 100,000. Peak incidence occurs between 10 and 14 years, with 90 % occurring in patients less than 25 years. They occur more frequently in males. Prognosis depends on the histological subtype, with a 10 year survival rate for germinomas of over 85 %. Other germ cell tumours have a lower survival rate, particularly those containing non-germinomatous malignant cells. Tumours often have intermediate signal on T1WI, slightly high signal on T2WI, and show contrast enhancement. They are typically centred on the pituitary stalk with the posterior pituitary bright spot often absent. They may look similar to Langerhans’ cell histiocytosis (LCH) or lymphocytic hypophysitis [53]. Contrast-enhancing disseminated subarachnoid and/or intraventricular tumour may occur through CSF seeding.

Bottom Line: The sellar and juxtasellar regions in the paediatric population are complex both anatomically and pathologically, with magnetic resonance imaging (MRI) being the "gold standard" imaging modality due to the high contrast of detail.Assessment requires a detailed understanding of the anatomy, embryology, pathophysiology and normal signal characteristics of the pituitary gland and surrounding structures in order to appropriately characterise abnormalities.This article aims to provide an overview of the imaging characteristics of developmental/congenital and acquired disease processes which affect the sellar and juxtasellar region in the paediatric population.

View Article: PubMed Central - PubMed

Affiliation: Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, 14642-0001, USA, rachel_shields@urmc.rochester.edu.

ABSTRACT
The sellar and juxtasellar regions in the paediatric population are complex both anatomically and pathologically, with magnetic resonance imaging (MRI) being the "gold standard" imaging modality due to the high contrast of detail. Assessment requires a detailed understanding of the anatomy, embryology, pathophysiology and normal signal characteristics of the pituitary gland and surrounding structures in order to appropriately characterise abnormalities. This article aims to provide an overview of the imaging characteristics of developmental/congenital and acquired disease processes which affect the sellar and juxtasellar region in the paediatric population. Main Messages • The sellar region is anatomically complex and covers a wide pathology spectrum. • MRI is the key imaging modality to assess sellar and juxtasellar pathology. • Numerous developmental anomalies may not be discovered until adulthood. • Knowledge of pathology alerts and guides the clinician towards appropriate management.

No MeSH data available.


Related in: MedlinePlus