{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:49:57Z","timestamp":1790034597081,"version":"4.0.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec>\n<jats:title>Context<\/jats:title>\n<jats:p>Disease processes that affect the pituitary stalk are broad; the diagnosis and management of these lesions remains unclear.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>The aim was to assess the clinical, biochemical and histopathological characteristics of pituitary stalk lesions and their association with specific MRI features in order to provide diagnostic and prognostic guidance.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Design and methods<\/jats:title>\n<jats:p>Retrospective observational study of 36 patients (mean age 37years, range: 4\u201383) with pituitary stalk thickening evaluated at a university hospital in Oxford, UK, 2007\u20132015. We reviewed morphology, signal intensity, enhancement and texture appearance at MRI (evaluated with the ImageJ programme), along with clinical, biochemical, histopathological and long-term follow-up data.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Diagnosis was considered certain for 22 patients: 46% neoplastic, 32% inflammatory and 22% congenital lesions. In the remaining 14 patients, a diagnosis of a non-neoplastic disorder was assumed on the basis of long-term follow-up (mean 41.3months, range: 12\u201384). Diabetes insipidus and headache were common features in 47 and 42% at presentation, with secondary hypogonadism the most frequent anterior pituitary defect. Neoplasia was suggested on size criteria or progression with 30% sensitivity. However, textural analysis of MRI scans revealed a significant correlation between the tumour pathology and pituitary stalk heterogeneity in pre- and post-gadolinium T1-weighted images (sensitivity: 88.9%, specificity: 91.7%).<\/jats:p>\n<\/jats:sec>\n<jats:sec><jats:title>Conclusions<\/jats:title>\n<jats:p>New techniques of MRI imaging analysis may identify clinically significant neoplastic lesions, thus directing future therapy. We propose possible textural heterogeneity criteria of the pituitary stalk on pre- and post-gadolinium T1 images with the aim of differentiating between neoplastic and non-neoplastic lesions with a high degree of accuracy.<\/jats:p>\n<\/jats:sec>","DOI":"10.1530\/eje-16-0455","type":"journal-article","created":{"date-parts":[[2016,7,15]],"date-time":"2016-07-15T02:44:03Z","timestamp":1468550643000},"page":"255-263","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":32,"title":["Pituitary stalk thickening: the role of an innovative MRI imaging analysis which may assist in determining clinical management"],"prefix":"10.1093","volume":"175","author":[{"given":"Emilia","family":"Sbardella","sequence":"first","affiliation":[{"name":"1Department of EndocrinologyOxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK"},{"name":"3Department of Experimental MedicineSapienza 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