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Sequential Pituitary MR Imaging in Sheehan Syndrome: Report of 2 Cases

J. Kaplun, C. Fratila, A. Ferenczi, W.C. Yang, G. Lantos, A.M. Fleckman and U.K. Schubart
American Journal of Neuroradiology May 2008, 29 (5) 941-943; DOI: https://doi.org/10.3174/ajnr.A1016
J. Kaplun
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C. Fratila
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A. Ferenczi
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W.C. Yang
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G. Lantos
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A.M. Fleckman
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U.K. Schubart
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    Fig 1.

    Case 1. Coronal (left) and sagittal (right) gadolinium enhanced T1-weighted MR images on postpartum day 26 show central low signal intensity and peripheral enhancement in the pituitary gland.

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    Fig 2.

    Case 1. Coronal (left) and sagittal (right) noncontrast T1-weighted MR images 6 months later show marked diminution in the size of the pituitary gland. There is CSF signal intensity in the sella (“empty sella”).

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    Fig 3.

    Case 2. Coronal (A) and sagittal (B) gadolinium-enhanced T1-weighted MR images on postpartum day 6 show a large low signal intensity sellar lesion with enhancement of the rim. There is extension into the suprasellar cistern, and the lesion abuts but does not compress the optic chiasm.

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    Fig 4.

    A and B, Case 2. At 5 weeks postpartum, the lesion is markedly smaller and no longer protrudes into the suprasellar cistern (image layout same as Fig 3).

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    Fig 5.

    A and B, Case 2. At 11 months postpartum, the sellar contents are markedly smaller, with a thin rim of enhancing tissue along the sellar floor (image layout same as Figs 3 and 4). CSF is noted in the sella (“empty sella”).

Tables

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  • Results of endocrine laboratory evaluation in Cases 1 and 2

    HormoneCase 1Case 2Normal Range
    TSH0.30.90.38–4.80 mU/L
    FT40.70.60.7–1.4 ng/dL
    Prolactin21.28.91.4–24.2 ng/mL
    ACTH<2.07.09–52 pg/mL
    Cortisol4.31.64.3–22.4 μg/dL
    FSH<0.50.01.1–95.8 mIU/mL
    LH<0.60.50.8–103.5 mIU/mL
    Estradiol22.15.012–400 pg/mL
    IGF-174.068.0114–492 ng/mL
    • Note:—TSH indicates thyroid-stimulating hormone; FT4, free thyroxine; ACTH, adrenocorticotropic hormone; FSH, follicular-stimulating hormone; LH, luteinizing hormone; IGF-1, insulin-like growth factor-1.

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American Journal of Neuroradiology: 29 (5)
American Journal of Neuroradiology
Vol. 29, Issue 5
May 2008
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Cite this article
J. Kaplun, C. Fratila, A. Ferenczi, W.C. Yang, G. Lantos, A.M. Fleckman, U.K. Schubart
Sequential Pituitary MR Imaging in Sheehan Syndrome: Report of 2 Cases
American Journal of Neuroradiology May 2008, 29 (5) 941-943; DOI: 10.3174/ajnr.A1016

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Sequential Pituitary MR Imaging in Sheehan Syndrome: Report of 2 Cases
J. Kaplun, C. Fratila, A. Ferenczi, W.C. Yang, G. Lantos, A.M. Fleckman, U.K. Schubart
American Journal of Neuroradiology May 2008, 29 (5) 941-943; DOI: 10.3174/ajnr.A1016
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