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Research ArticleHead and Neck Imaging

Optic Nerve Hyperintensity on T2-Weighted Images among Patients with Pituitary Macroadenoma: Correlation with Visual Impairment

A.M. Tokumaru, I. Sakata, H. Terada, S. Kosuda, H. Nawashiro and M. Yoshii
American Journal of Neuroradiology February 2006, 27 (2) 250-254;
A.M. Tokumaru
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I. Sakata
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H. Terada
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S. Kosuda
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H. Nawashiro
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M. Yoshii
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    Fig 1.

    Degree of optic chiasmal compression. A, No compression to optic chiasma (−). B, Compression of less than half of the optic chiasm (+). C, Compression with marked thinning (++).

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    Fig 2.

    Correlation between abnormal signal intensity of optic nerve and tumor size.

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    Fig 3.

    Correlation between abnormal signal intensity of optic nerve and optic chiasm compression.

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    Fig 4.

    Correlation between abnormal signal intensity of optic nerve and improvement after treatment of VA.

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    Fig 5.

    Case 3, a 42-year-old woman whose disease duration was 6 months. Right VA disturbance was recognized (right VA = 0.02; left VA = 1.5). A, Pituitary macroadenoma markedly compressed the optic chiasm especially the right side (white arrows). B–E, Hyperintensity was recognized in the right optic nerve on T2-weighted image (arrows). F–H, Hyperintensiy in the right optic nerve lasted for 2 years after the tumor reduction (arrows).

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    Fig 6.
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    Fig 6.

    Case 17, a 58-year-old man, whose disease duration from the initial examination to the operation was 26 months. VA was not stable, though fixed VA disturbance was not recognized on the initial examination. A, Pituitary adenoma compressed the optic chiasm. B, Hyperintensiy of the optic nerve was not shown (arrows) on the initial examination. C, Right-side perioptic subarachnoid space dilated slightly on the initial examination (arrow). D and E, Tumor reduction was performed 26 months after the initial examination. Hyperintensity was shown in the bilateral optic nerve ventral to the optic chiasm (D, white arrows) and bilateral perioptic subarachnoid space dilated markedly (E, white arrows), probably representing atrophic change of the optic nerves.

Tables

  • Figures
  • Optic tract hyperintensity on T2-weighted images among patients with pituitary macroadenoma: correlation with visual impairment

    Patient No./Age (y)/SexDurationSize (mm)OCASVADVFDPathologyIAT
    1/36/M2 mo18−−−+
    2/61/M9 y23.7+−+ (rt 0.7, lt blind)+PA−
    3/42/F16 mo26.5++++ (rt 0.02, lt 1.5)+PA (corticotro)−
    4/38/F10 mo14−−−+
    5/40/M6 mo35++++ (rt 0.07, lt 0.05)+PA (null)−
    6/55/F4 y46++++ (rt 0.06, lt 0.06)+PA (chromophobe)−
    7/65/F2 mo13−−−+PA (null)
    8/74/M18 mo16.4+++ (rt 0.7, lt 0.4)+PA (null)−
    9/54/F3 mo27+++ (rt 0.06, lt 0.1)+PA (nonfunctioning)+ (rt 1.2, lt 0.8)
    10/65/M2 mo13−++ (rt light sense)+Pituitary carcinoma−
    11/59/F14 mo35++++ (rt 0.3, lt 0.9)+PA (null)−
    12/55/M3 mo22++++ (rt 0.5, lt 0.1)+PA+ (rt 1.0, lt 1.0)
    13/41/F19 mo25++++ (hand sense)+PA (null)−
    14/37/F3 mo16−−−+
    15/70/F6 mo18+++ (rt 0.1, lt blind)−
    16/27/M6 mo15−++ (finger sense)+PA (chromophobe)+ (rt 0.7, lt 0.9)
    17/58/M26 mo24++++ (rt 1.5, lt 0.4)−PA (null)−
    18/21/F8 mo30+−−+PA (GH)−
    19/50/F10 y51++++ (rt 0.03, lt 0.1)+PA(FSH-LH)−
    20/74/F1.5 mo18−++ (lt light sense)−PA (prolactinoma)+ (rt 0.8, lt 0.4)
    21/66/F2 mo15−−−−PA (null)
    22/63/M2 mo23.7++++ (rt 0.1, lt 0.7)+PA (chromophobe)+ (rt 0.7, lt 0.8)
    23/54/F3 mo13−−−−PA
    24/56/F3 mo20−−−−PA
    25/45/M2 mo16−−−+PA (chromophobe)
    26/36/M2 mo12.2−−−−
    27/50/M3 mo16++++ (rt 0.9, lt 0.3)+PA (GH)+ (rt 0.9, lt 0.7)
    • Note.—OC indicates optic chiasm compression; AS, abnormal signal in optic nerve; VAD, visual acuity disturbance; VFD, visual field disturbance; IAT, improvement of visual acuity after treatment; PA, pituitary adenoma; FSH-LH, follicle stimulating hormone-luteinizing hormone; GH, growth hormone.

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American Journal of Neuroradiology: 27 (2)
American Journal of Neuroradiology
Vol. 27, Issue 2
February, 2006
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Cite this article
A.M. Tokumaru, I. Sakata, H. Terada, S. Kosuda, H. Nawashiro, M. Yoshii
Optic Nerve Hyperintensity on T2-Weighted Images among Patients with Pituitary Macroadenoma: Correlation with Visual Impairment
American Journal of Neuroradiology Feb 2006, 27 (2) 250-254;

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Optic Nerve Hyperintensity on T2-Weighted Images among Patients with Pituitary Macroadenoma: Correlation with Visual Impairment
A.M. Tokumaru, I. Sakata, H. Terada, S. Kosuda, H. Nawashiro, M. Yoshii
American Journal of Neuroradiology Feb 2006, 27 (2) 250-254;
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