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T1 Signal Hyperintensity in the Sellar Region: Spectrum of Findings¹

¹ From the Department of Neuroradiology, Pitié-Salpêtrière Hospital, 74 Boulevard de l’Hôpital, 75013 Paris, France (F.B., D.D., J.C.); Department of Neuroradiology, Jean Minjoz Hospital, Besançon, France (F.C., J.F.B.); and Department of Neuroradiology, Bicêtre Hospital, Le Kremlin-Bicêtre, France (K.M.). Recipient of an Excellence in Design award for an education exhibit at the 2004 RSNA Annual Meeting. Received March 7, 2005; revision requested April 12 and received May 4; accepted May 5. All authors have no financial relationships to disclose. Address correspondence to F.B. (e-mail: fabrice.bonneville{at}psl.ap-hop-paris.fr).

T1 signal hyperintensity is a common finding at magnetic resonance imaging of the sellar region. However, this signal intensity pattern has different sources, and its significance depends on the clinical context. Normal variations in sellar T1 signal hyperintensity are related to vasopressin storage in the neurohypophysis, the presence of bone marrow in normal and variant anatomic structures, hyperactive hormone secretion in the anterior pituitary lobe (eg, in newborns and pregnant or lactating women), and flow artifacts and magnetic susceptibility effects. Pathologic variations in T1 signal hyperintensity may be related to clotting of blood (in hemorrhagic pituitary adenoma, pituitary apoplexy, Sheehan syndrome, or thrombosed aneurysm) or the presence of a high concentration of protein (Rathke cleft cyst, craniopharyngioma, or mucocele), fat (lipoma, dermoid cyst, lipomatous meningioma), calcification (craniopharyngioma, chondroma, chordoma), or a paramagnetic substance (manganese, melanin). After treatment, T1 signal hyperintensity may result from the presence of materials used for surgical packing (gelatin sponge, fat); from compression of the cavernous sinus and reduction of the venous flow, caused by overpacking of the operative bed; or from hormone hypersecretion by a remnant of normal tissue in the anterior lobe of the pituitary gland.

© RSNA, 2006

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