Article Figures & Data
Figures
- Fig 1.
Patient 1. A 65-year-old woman presented with classic pituitary apoplexy manifesting as a sudden onset of severe headache, nausea, vomiting, and visual disturbance. Also, she became drowsy because of severe dehydration and hyponatremia. A, Sagittal T1-weighted MR image showing low- to isointense masses in the nonenhanced pituitary lesion with diffuse high signal intensity. B, Sagittal T2-weighted MR image showing dark masses in the mixed high signal intensity area. C, Coronal T2*-weighted gradient-echo image showing dark masses indicating hematoma (white arrows). D, Photomicrograph showing hemorrhage and a small amount of chromophobic adenoma (H&E, original magnification ×40).
- Fig 2.
Patient 2. A 30-year-old man presented with subacute hematoma manifesting as right temporal hemianopia and progressive right visual disturbance. He occasionally had a mild headache but no sudden and eventful headaches. His serum prolactin level was 533.2 ng/mL. A, Coronal T1-weighted MR image showing a large pituitary lesion containing a large area of high signal intensity. B, Coronal T2-weighted MR image showing a large area of low signal intensity with a marked low signal intensity rim. C, Coronal T2*-weighted GE image showing low intensity hematomas with a clear dark rim (white arrow), and a dark mass in the solid portion of the tumor (white arrowhead). D, Photomicrograph showing hemorrhage in chromophobic adenoma (H&E, original magnification ×40).
- Fig 3.
Patient 3. A 43-year-old man had typical cysts in a nonfunctioning adenoma. A, Coronal T1-weighted MR image showing a large pituitary lesion. B, Coronal T2-weighted MR image showing the equivocal hypointense rim of a cyst (white arrowheads). C, Coronal T2*-weighted GE image showing the faint hypointense rim of a cyst (white arrows). D, Photomicrograph showing hemorrhage in chromophobic adenoma (H&E, original magnification ×40).
- Fig 4.
Patient 4. A 39-year-old woman had a solid nonfunctioning pituitary adenoma without cyst or hematoma. She had no past or present headache. A, Coronal T1-weighted MR image showing the isointense tumor. B, Coronal T2-weighted MR image showing the mixed high signal intensity pituitary lesion. C, Coronal T2*-weighted GE image showing diffuse dark appearance of the adenoma. D, Photomicrograph showing hemorrhage in chromophobic adenoma (H&E stain, original magnification ×40).
Tables
Intratumoral dark lesions on T2*-weighted GE MR imaging and other hemorrhagic findings
Signs Relating to Intratumoral Hemorrhage Intratumoral Dark Lesions on T2*-Weighted GE MR Imaging P Value Yes No Intratumoral high intensity on T1-weighted FSE MR imaging <.02* Yes 7 1 No 5 12 Intratumoral dark lesions on T2-weighted FSE MR imaging <.01* Yes 8 1 No 4 12 Intraoperative findings of intratumoral hemorrhage <.001* Yes† 10 0 No 2 13 Histologic findings of intratumoral hemorrhage <.001* Yes‡ 12 4 No 0 9 Note:—GE indicates gradient-echo; FSE, fast spin-echo.
* Statistically significant.
† Cysts including xanthochromic fluid, liquefied hematoma, and coagulation.
‡ Positive histologic hemorrhagic finding (++ or +).
