What lesions can be detected by pituitary enhancement examination?
Sep 02, 2025
Source: Cainiu Health
Dr. Yang Ziqi
Introduction
In general, pituitary enhancement examination can clearly display abnormalities of the pituitary gland and surrounding tissues. Common detectable lesions mainly include pituitary adenomas, pituitary inflammation, pituitary cysts, pituitary apoplexy, and pituitary metastases. Prior to undergoing pituitary enhancement examination, patients should discontinue medications affecting the contrast agent as directed by the physician. After the examination, appropriate water intake is recommended to help excrete the contrast agent.
Generally, pituitary enhancement examination can clearly display abnormalities of the pituitary gland and surrounding tissues. Common detectable lesions mainly include pituitary adenoma, hypophysitis, pituitary cyst, pituitary apoplexy, and pituitary metastases. Detailed analysis is as follows:
1. Pituitary Adenoma: During pituitary enhancement scanning, typical adenomas often demonstrate mild enhancement or uneven enhancement, differing from the enhancement level of normal pituitary tissue. Some large adenomas may compress the optic nerve, optic chiasm, or surrounding blood vessels, causing displacement of corresponding structures. This examination can determine the size, location, and extent of the adenoma, helping assess whether pituitary function is affected.
2. Hypophysitis: Different types of hypophysitis present differently. Lymphocytic hypophysitis often shows diffuse enhancement and overall enlargement of the pituitary gland with irregular morphology during enhanced scanning; granulomatous hypophysitis may present with localized enhancing nodules. The examination can differentiate inflammation from other space-occupying lesions and assist in determining the extent of inflammation and its impact on surrounding tissues.
3. Pituitary Cyst: Cysts typically appear as well-defined non-enhancing areas with uniform low density on pituitary enhancement examination, showing a clear contrast with the surrounding enhanced pituitary tissue. The examination can accurately reveal the cyst's size, location, and whether it is compressing normal pituitary tissue, aiding clinical judgment on whether intervention or treatment is necessary.
4. Pituitary Apoplexy: When sudden hemorrhage or infarction occurs in a pituitary adenoma, the enhanced scan reveals non-enhancing hemorrhagic or infarcted areas within the lesion, with possible ring-like enhancement of the surrounding adenoma tissue. This examination can rapidly identify apoplectic changes, determine the extent of hemorrhage or infarction, and provide crucial reference for developing emergency management strategies.
5. Pituitary Metastases: When primary tumors metastasize to the pituitary gland, enhanced scanning typically presents as multiple or solitary nodular enhancements, often accompanied by pituitary enlargement. Some metastatic tumors may invade the pituitary stalk. This examination can detect metastases and, combined with medical history, assist in identifying the primary tumor and assessing the severity of the disease.
Prior to undergoing pituitary enhancement examination, patients should discontinue medications affecting contrast agents as directed by their physician. After the examination, appropriate water intake is recommended to promote contrast agent excretion. Maintaining regular rest and avoiding excessive fatigue in daily life will provide a good physical condition for subsequent diagnosis and treatment.
