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The Role of Magnetic Resonance Imaging (MRI) in Diagnoses of Pituitary Gland

The pituitary gland is a part of the endocrine system that is physically a small pea-sized structure located in the head region in humans. It protrudes from the lower part of the hypothalamus, which is positioned at the base of the human brain. The Sella turcica, a sphenoid bone of the skull, houses the gland that is consisted of two structurally and functionally different sections called the anterior and the posterior lobes (Turcu, 2013). Between the two lobes is a small flake of tissues referred to as the intermediate lobe used to synthesize and secrete melanocyte-stimulating hormones. The anterior lobe of the pituitary gland is responsible for regulating a number of physiological processes such as stress, growth and development, as well as he reproduction process. The posterior lobe is functionally attached to the hypothalamus through a small tube known as a pituitary stalk (Gregory, 2013). The hormones of the anterior pituitary are all proteins or polypeptides. The major hormones secreted by the gland include the growth hormone (somatotrophin), prolactin, adrenocorticotrophic hormone (corticotrophin), melanocyte-stimulating hormone, thyroid-stimulating hormone (thyrotrophin), and the follicle-stimulating hormone and luteinizing hormone (gonadotrophins).  The basic anatomy of the pituitary gland can be represented in the diagram below figure (1).
Figure 1: The Pituitary Gland (Gregory, 2013).
An extensive array of lacerations that are usually experienced in the pituitary gland, or the surrounding parts, are a common cause of the gland infections and diseases. These effects all are presented with medical symptoms and indications that are usually related to a dysfunctional endocrine system, local effects of a tumor in the area of the gland for the nearby parts, or even from non-particulate causes of an increasing intracranial mass (Turcu, 2013). Tumors in the interior of the pituitary gland include adenoma, metastatic carcinoma, carcinoma, leukemia, germ cell tumors, granular cell tumors such as spindle cell granular oncocytoma, ganglioglioma, pituicytoma, meningioma, lymphoma, nodular, abscess, lymphocytic hypophysitis, among several others  (Guo, 2015). Tumors that arise from nearby interior parts include pilocytic astrocytoma of the optic chiasm/nerve, schwannoma of the cranial nerves, gangliocytoma & pilocytic astrocytoma of the hypothalamus, as well as meningioma, paraganglioma & chondrosarcoma of the sella turcica.

In this research, the main aim is to investigate the role of MRI in the examination for assessing pituitary-associated endocrine diseases. The satisfactory neurotic assessment of pituitary adenomas needs broad immunocyto chemistry as well as electron microscopy. Magnetic resonance imaging is used for the detection of pituitary lesions in humans. The principal behind it is the observation that pituitary adenomatous tissue in a patient with pituitary-dependent sensitivity is usually hypointense and can be distinguished from normal hyperintense pituitary tissue. Experiences with this diagnostic imaging modality in veterinary medicine is rapidly increasing.  Magnetic Resonance Imaging is used nowadays in imaging of the pituitary gland and the surrounding structures such as brain tissue and blood vessels.

Imaging the pituitary gland is important since it is used to effectively confirm the identification of pituitary lacerations. The process is similarly essential for determination of the differential analysis of other sellar lacerations. The basic skull imaging techniques are not effective at outlining the soft tissue and part of the head, and are thus used nowadays for diagnosis of inner tissue pathologies. The extent of sella in a radiograph is not as subtle as needed to indicate the abnormality of the pituitary gland, as subsequently, an empty sella leads to enlargement of its size. As such, plain radiographs have been substituted by better soft tissues imaging practices such as Computed tomography scanning and Magnetic Resonance Imaging.
Computed tomography scan, although lesser regularly used for the assessment of sellar and parasellar lacerations, is valuable in depicting soft tissue calcification, destructions of the bones, and surgically pertinent bony make-up  (Guo, 2015). They are usually valuable when Magnetic resonance imaging is controverted, such as in patients who have any metallic implant in the head region. Nevertheless, fewer optimum soft tissue contrast and very low radiation exposure feature as the significant shortcomings limiting the cautious use of computed tomography for assessing pituitary lesions.
Presently, Magnetic Resonance Imaging is the analysis of superior preference for sellar pathologies since it has loftier soft tissues contrasts, multiplanar ability and has no ionizing radiation. Additionally, it also displays valuable data showing the relationship between the gland and adjacent anatomical structures, which significantly aids in planning medical or surgical strategies.
Magnetic resonance imaging procedures used in establishing pituitary lacerations have watched a swift development, going from the noncontrast magnetic resonance techniques of late 80s to contrast-boosted Magnetic Resonance Imaging in mid-90s (Guo, 2015). The invention of active contrast-enhanced MRI has additionally advanced this practice in establishing pituitary adenomas. In recent times, a diversity of innovative Magnetic Resonance practices have been advanced which are predominantly supportive in assessing precise cases. They consist of 3D volumetric examination of pituitary volume, high-resolution MR imaging at 3 Tesla for assessing pituitary stalk, diffusion-weighted imaging, magnetization transfer ratio, and intraoperative Magnetic Resonance Imaging.
This research covers the following areas detailing the role of MRI in the diagnosis of pituitary gland.
The anatomy of pituitary gland (Ball, 1969).
The common pathology of pituitary gland (Ezzat, 2004).
The best sequences and facts for imaging the pituitary
The role of injection contrast to diagnose microadenoma the best amount of contrast to get good image (Bonneville, 2005).
The best technique to get good enhanced pituitary gland and to get clear image for any abnormality.

Several online databases shall be searched and through a pre-set systematic inclusion criteria, several peer-reviewed articles shall then be selected and they are upon which this research will be based. Other quality sources of information regarding to the role of MRI in the diagnosis of pituitary gland such as reports, textbooks, and information from secondary sources such as research results shall also be used. Qualitative approaches shall be employed to synthesize the influence and demonstrate, clarify, and deliver background knowledge of the use and best practice imaging modalities used in evaluating pituitary gland lesions.


This research involve extensive searching for supporting evidence to show the effective usage of the MRIs in the imaging of the pituitary gland and its surrounding structures. Thus it calls for use of previous research platforms and results of the day to day usage of the MRIs.

Myers-Schulz, B., & Koenigs, M. (2012). Functional anatomy of ventromedial prefrontal cortex: implications for mood and anxiety disorders. Molecular psychiatry, 17(2), 132-141.
Schreibman, M. P. (2012). Pituitary gland. Vertebrate endocrinology: fundamentals and biomedical implications, 1, 11-55.
Gregory, L. C., Gevers, E. F., Baker, J., Kasia, T., Chong, K., Josifova, D. J., ... & Dattani, M. T. (2013). Structural pituitary abnormalities associated with CHARGE syndrome. The Journal of Clinical Endocrinology & Metabolism, 98(4), E737-E743.
Dass, S., Suttie, J. J., Piechnik, S. K., Ferreira, V. M., Holloway, C. J., Banerjee, R., ... & Neubauer, S. (2013). Response to Letter Regarding Article,“Myocardial Tissue Characterization Using Magnetic Resonance Noncontrast T1 Mapping in Hypertrophic and Dilated Cardiomyopathy”. Circulation: Cardiovascular Imaging, 6(2), e2-e2.
Dall’Armellina, E., Piechnik, S. K., Ferreira, V. M., Si, Q. L., Robson, M. D., Francis, J. M., ... & Neubauer, S. (2012). Cardiovascular magnetic resonance by non contrast T1-mapping allows assessment of severity of injury in acute myocardial infarction. J Cardiovasc Magn Reson, 14(1), 15.
Guo, Q., Young, W. F., Erickson, D., & Erickson, B. (2015). Usefulness of dynamic MRI enhancement measures for the diagnosis of ACTH‐producing pituitary adenomas. Clinical endocrinology, 82(2), 267-273.
Turcu, A. F., Erickson, B. J., Lin, E., Guadalix, S., Schwartz, K., Scheithauer, B. W., ... & Young Jr, W. F. (2013). Pituitary stalk lesions: the Mayo Clinic experience. The Journal of Clinical Endocrinology & Metabolism, 98(5), 1812-1818.
Mullins, M. E. (2014). Diffusion-Weighted Imaging of the Pituitary Gland. American Journal of Neuroradiology, 35(1), 99-99.
Park, M., Lee, S. K., Choi, J., Kim, S. H., Kim, S. H., Shin, N. Y., ... & Ahn, S. S. (2015). Differentiation between Cystic Pituitary Adenomas and Rathke Cleft Cysts: A Diagnostic Model Using MRI. American Journal of Neuroradiology.
Chaudhary, V., & Bano, S. (2011). Imaging of the pituitary: Recent advances. Indian journal of endocrinology and metabolism, 15(Suppl3), S216.

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