Summary Thoughts: Parapharyngeal Space The 4 key spaces of the suprahyoid neck (SHN) surround the parapharyngeal space (PPS), which is the fat-filled lateral SHN space. When large lesions of the SHN become hard to localize to a space of origin,…
Imaging Approaches & Indications Neither CT nor MR is a perfect modality for imaging the extracranial H&N. MR is most useful in the suprahyoid neck (SHN) because it is less affected by oral cavity dental amalgam artifact. The SHN tissue…
Introduction Rapid advancement of medical imaging in the last few decades has significantly enhanced the role of imaging in medicine. Imaging plays an integral role in the evaluation of many of the diseases confronted by the otolaryngologist. It is performed…
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KEY FACTS Terminology Benign, often partially cystic sellar region tumor derived from Rathke pouch epithelium 2 types Adamantinomatous (cystic mass in childhood) Papillary (solid mass in older adults) Imaging General features Multilobulated, often large (> 5 cm) Occasionally giant, multicompartmental…
KEY FACTS Terminology Nonneoplastic cyst arising from remnants of embryonic Rathke cleft Benign sellar region endodermal cyst lined by ciliated, mucus-producing epithelium Imaging Nonenhancing, noncalcified, intrasellar &/or suprasellar cyst with intracystic nodule Completely intrasellar (40%), suprasellar extension (60%) Density/signal intensity…
KEY FACTS Terminology Acute clinical syndrome with headache, visual defects/ophthalmoplegia, altered mental status, variable endocrine deficiencies Caused by either hemorrhage or infarction of pituitary gland Preexisting pituitary macroadenoma common Imaging CT Sellar/suprasellar mass with patchy or confluent hyperdensity Peripheral enhancement,…
KEY FACTS Terminology Benign neoplasm of adenohypophysis Imaging Upward extension of macroadenoma = most common suprasellar mass in adults Best imaging technique MR with sagittal/coronal thin-section imaging through sella + T1 C+ with FS Sellar mass without separate identifiable pituitary…
KEY FACTS Terminology Microadenoma: ≤ 10 mm in diameter Imaging Intrasellar mass is typical location Rare: Ectopic origin outside pituitary fossa Best technique = dynamic contrast-enhanced thin-section T1-weighted MR Generally enhance more slowly than adjacent normal pituitary Beware: 10-30% can…
KEY FACTS Terminology Congenital anomalies of pituitary stalk → potential hypothalamic/pituitary axis malfunction Imaging Posterior pituitary ectopia (PPE) Duplicated pituitary gland/stalk (DP) PPE: No (or tiny) pituitary stalk, ectopic posterior pituitary on midline sagittal T1WI MR Look for associated anomalies:…