Article Figures & Data
Figures
- FIG 1.
Precontrast T1-weighted sagittal images show the 3 types of sphenoid sinus pneumatization seen in our patients. Type 2 (presellar): the posterior wall of the sphenoid sinus is in front of the anterior wall of the sella turcica; type 3 (sellar): the posterior wall of the sphenoid sinus is between the anterior and posterior wall of the sella turcica; type 4 (postsellar): the posterior wall of the sphenoid sinus is located behind the posterior wall of the sella turcica. An example of type 1 (conchal type, minimal air in the sphenoid sinus) is not shown because this is uncommon and we did not have a patient with this pneumatization pattern.
- FIG 2.
MR images of patient 1 with idiopathic GH and type 3 (sellar) sphenoid sinus pneumatization. Precontrast T1-weighted sagittal image (A) shows low signal in the infrasellar basisphenoid bone marrow. This low signal corresponds to bone marrow enhancement below the sella (arrows) seen on sagittal (B) and coronal (C) T1-weighted fat-saturated postcontrast images.
- FIG 3.
MR images of patient 2 with idiopathic GH and type 3 (sellar) sphenoid sinus pneumatization. This is a collage of images of a single patient at baseline before intervention (upper row) followed by postbiopsy and post-steroid treatment. Left to right, Coronal T2-weighted, precontrast sagittal T1-weighted, fat-saturated postcontrast sagittal T1-weighted, and fat-saturated postcontrast coronal T1-weighted images show diffuse infrasellar basisphenoid bone marrow–enhancing edema (arrows) on baseline that resolved 6 months later after biopsy and steroids.
- FIG 4.
MR images of patient 3 with secondary GH from sarcoidosis. These show preoperative edema (A, coronal T2-weighted image) and enhancement (B, postcontrast coronal T1-weighted image) of the infrasellar basisphenoid bone marrow. After biopsy and oral dexamethasone, follow-up imaging 7 months later shows resolution of the edema (C, coronal T2-weighted image) and enhancement (D, postcontrast coronal T1-weighted image) with a decreased size of the pituitary mass.
- FIG 5.
MR images of 2 patients with large pituitary adenomas demonstrate the typical nonenhancing basisphenoid bone marrow. Precontrast (1A/2A) and fat-saturated postcontrast (1B/2B), sagittal T1-weighted images without basisphenoid bone marrow enhancement. Both patients have type 2 pneumatization of the sella.
- FIG 6.
A large pituitary adenoma on precontrast sagittal T1-weighted (A), postcontrast sagittal (B), and coronal (C) T1-weighted images shows focal bone marrow enhancement in the right anterior and lateral aspect of the basisphenoid. This is a distinct pattern from the diffuse enhancement in patients with GH.
