European Journal of Cardiovascular Medicine

Background: The study was conducted to evaluate the use of dynamic contrast magnetic resonance imaging as a modality to identify various lesions in pituitary gland and sella, characterize and document various enhancement pattern of pituitary lesions with clinical and histopathological correlation and compare non contrast MRI vs dynamic contrast MRI in evaluating pituitary lesions. Methods: This was a hospital based cross sectional study conducted among 30 patients who presented with pituitary dysfunction to the Department of Radio-Diagnosis and Imaging, Government General Hospital, Kurnool Medical College (KMC), Kurnool, from November 2019 to November 2021 after obtaining clearance from institutional ethics committee and written informed consent from the study participants. Results: Neoplastic lesions are the most common type of pituitary lesions. Pituitary adenomas were mostly found in females. Macroadenomas were more common than microadenomas. The most common clinical feature of macroadenoma was headache. The most frequent cystic lesions were macroadenomas, Macroadenoma constituted the most cases which showed blooming on SWI. In dynamic contrast enhancement pattern, majority of cases show homogenous enhancement and least common pattern was rim enhancement. MRI majority of cases enhance between 0 to 60 seconds (early phase) and (16.6%)% of cases enhance between 60 to 200 seconds (late phase). Among microadenomas, 83.3% enhance in late phase of dynamic study.  Whereas in MRI diagnosis vs. histopathology diagnosis, out of 13 MRI diagnosed Macroadenoma, 1 case turned out to be sellar meningioma. Out of 4 MRI diagnosed craniopharyngioma, 1 case turned out to be Rathke cleft cyst. Conclusion: Knowledge of the normal anatomy and pathologic imaging appearance of sellar lesions is essential in the interpretation of MR imaging of brain and pituitary. The wide spectrum of sellar masses often present with similar symptoms. Accurate imaging characterization and early diagnosis are capable of providing significant clinical benefits.