The purpose of the study was to evaluate the utility of MRI and CT in
the diagnosis of Nelson's syndrome, i.e. pituitary tumours in patients
bilaterally adrenalectomized for Gushing's disease. Thirteen patients
, followed up for 5-29 years after adrenalectomy were studied. In 6 of
them CT and MRI revealed no changes in the pituitary gland. In the re
maining 7 patients only three CT scans were suggestive of a pituitary
adenoma. MRI studies with administration of gadodiamide confirmed the
CT diagnosis of Nelson's tumour in 3 patients and disclosed microadeno
mas in a further 4 patients. Neurosurgical treatment in 4 patients con
firmed the MRT findings. Additionally CT and MRI examinations were per
formed in 5 patients suspected of a recurrent Nelson's tumour 3-11 yea
rs after neurosurgery. MRI visualized recurrent adenomas in 3 patients
that were not well seen by CT scans. In our experience MRI was more e
ffective than CT in the diagnosis of Nelson's syndrome.