HEMORRHAGE IN PITUITARY-ADENOMA - CORRELATION OF MR-IMAGING WITH OPERATIVE FINDINGS

The aim of this study was to correlate MR imaging and operative findin gs of hemorrhage in pituitary macroadenomas. We retrospectively review ed MR images of 113 surgically proven pituitary adenomas. Al patients were examined on a 1.5-T MR system. The intensity of intratumoral cyst ic cavities was correlated with operative findings. In 15 patients wit h pituitary apoplexy, we determined relationship between interval of M R examination after apoplectic event and MR signal intensity. In 8 pat ients with repeated preoperative MR examination: we evaluated sequenti al changes of intratumoral hemorrhage. There were 54 cavities at surge ry: 52 were hemorrhagic and 2 were nonhemorrhagic. Twenty-nine of 52 h emorrhagic cysts demonstrated high/low signal (H/L) fluid-fluid levels on T2-weighted image (T2WI), In 19 of them, two components could be s eparately seen at operation: the supernatant high-intensity area repre sented xanthochromic fluid, and the dependent low-intensity area repre sented liquefied hematoma. The H/L fluid-fluid level was observed pred ominantly in hematomas on MR images obtained after longer intervals. I n patients with repeated MR examination, follow-up MR imaging revealed additional hemorrhage or new formation of fluid-fluid levels. It was surprising that 12 of 14 cysts preoperatively judged as nonhemorrhagic in fact contained hemorrhagic components. The preoperative MR images are well correlated to the operative findings in hemorrhagic pituitary macroadenomas. It proved that 52 of 54 cystic cavities had hemorrhagi c component.