Radiology, Vol 187, 857-861, Copyright © 1993 by Radiological Society of North America
Pituitary microadenomas: early enhancement with dynamic CT-- implications of arterial blood supply and potential importance
JF Bonneville, F Cattin, W Gorczyca and J Hardy
Department of Neuroradiology, University Hospital, Besancon, France.
In a search for early contrast medium enhancement, which can indicate the
presence of direct arterial supply, a retrospective review of dynamic
computed tomographic (CT) scans was performed in 260 patients with a
pituitary microadenoma smaller than 10 mm in diameter. Fifty patients
underwent examination with dynamic CT for nonendocrinologic disease as a
control group to establish the normal pattern of pituitary gland
enhancement. One hundred seventy microadenomas (65.4%) displayed the usual
dynamic CT pattern (ie, they did not show early enhancement before that of
the portal system of the pituitary gland: those pituitary microadenomas
appeared less enhanced than the normal pituitary gland during the entire
examination). On the other hand, in 90 microadenomas (34.6%), early partial
or complete enhancement was seen within the microadenoma before the normal
portal enhancement of the gland. Therefore, analysis with dynamic CT yields
two groups of pituitary microadenomas separable on the basis of blood
supply: those with portal blood supply only and those with partial or
predominantly direct arterial blood supply; in theory, the second group
avoids hypothalamic control.
