RADIOLOGIC IMAGING OF

THE ENDOCRINE - METABOLIC SYSTEM

DR. HERMAN PIETER L. W, SP.RAD

SMF RADIOLOGI FK UNDANA

MODALITIES :
•CONVENTIONAL X-RAY
•ULTRASOUND
•C T
•NUCLEAR MEDICINE
•M R I
Roentgen : X-ray machine
USG
NUCLEAR MEDICINE
1. SKELETON
2. L I V E R
3. L U N G S
4. THYROID/PARATHYROID; ADRENAL
5. H E A R T
6. K I D N E Y
7. ABSCESS & INFLAMMATION
MRI
Mammography
1. PITUITARY GLAND
NORMAL
•SELLA TURCICA
•ANTERIOR LOBE
•POSTERIOR LOBE
•STALK
• EMPTY SELLA
- INCIDENTAL FINDING.
- CONGENITAL AND ACQUIRED
- CONGENITAL : DEFECT IN THE DIAPHRAGM SELLAE.
- ACQUIRED : ANTERIOR PITUITARY HAEMORRHAGE OR
FROM INFARCTION OF A PITUITARY ADENOMA.
CT AND MRI
• THE PITUITARY GLAND IS FLATTENED TO A THIN RIM ALONG THE
FLOOR OF THE SELLA TURCICA.
• THEPITUITARY STALK REMAINS IN ITS NORMAL POSITION
(CYSTIC TUMOR : STALK REPLACED OR OBLITERATED)
• OCCASIONALLY, INTRASELLAR HERNIATION OF THE OPTIC NERVE,
CHIASM OR TRACT INTO THE EMPTY SELLA.
PITUITARY GLAND

•BENIGNA :
1. ADENOMA :
- SMALL
- ENCAPSULATED
- SELLA TURCICA EROTION
ADENOMA
IMAGING :
• MICROADENOMA < 1 CM : SELLA TURCICA SHOW
MINIMAL OR NO ENLARGEMENT
• MACROADENOMA > 1 CM : ENLARGMENT SELLA
TURCICA
CRANIOPHARYNGIOMA (ADAMANTINOMA
• MORE THAN ADENOMA
• CHILDHOOD AND YOUNG ADULT
• BENIGN  MALIGNANT
• INTRASELLAR OR OUTSIDESELLAR
• ENCAPSULATED
• SOLID OR CYSTIC (MULTILOCULAR)
• CALCIFIED
2. PINEAL GLAND (EPIPHYSIS CEREBRI)

PATHOLOGY :
- PINEALOMA : FIBROTIC
- NEUROGLIOMA (GLIOMA)
- TERATOMA : CALCIFIED
3. THYROID :

• AGENESIS : SMALL THYROID

• ECTOPIC THYROID : LINGUAL, UPPER NECK,
MEDIASTINUM
• THYROGLOSSAL DUCT CYST : CYST AT MIDLINE .
GOITER :
•SIMPLE : DIFFUSE SYMMETRICAL ENHANCEMENT.
•HYPERPLASTIC : DIFFUSE ENLARGEMENT
(SECONDARY HYPERTHYROIDISM-GRAVE’S DISEASE)
•NODULAR GOITER : CYST, SOLID, CALCIFIED.
4. PARATHYROID GLAND

• USUALLY FOUR CONSIST OF SMALL (< 0,5 CM) 30

TO 35 MG ENCAPSULATED MASSES
• NEOPLASMA
- ADENOMA
-CARCINOMA
5. PANCREAS
•NORMAL
•PANCREATITIS ACUTE
•PANCREATITIS CHRONIC
•NEOPLASM
PANCREATITIS ACUTE :
• DIFFUSE ENLARGEMENT
• HYPOECHOGENIC (US), INCREASED DENSITY
OF PERIPANCREATIC FAT AND ENHANCES
HOMOGENEOUSLY WITH CM (CT)
PANCREATITIS CHRONIC :
• CALCIFICATION
• DILATATION OF THE PANCREATIC DUCT
• ATROPHY OF THE GLANDULAR TISSUE
NEOPLASM
• HEAD, BODY OR TAIL
•HEAD : FOCAL ENLARGEMENT, PANCREATIC DUCT
DILATATION UP TO 5-10 MM, AS WELL AS
BILIARY TRACT DILATATION (> 50 % PATIENTS)
•OBLITERATION OF THE PERIPANCREATIC FAT
•ENLARGEMENT LYMPHNONE CELIAC AND SMA
•LIVER METASTASES ARE COMMON
6. ADRENAL GLAND
ADENOMA
•UNILATERAL
•WELL-DEFINED
•HOMOGENEOUS MASS 2-4 CM IN DIAMETER
•DENSITY FROM SOFT TISSUE TO WATER
PHEOCHROMOCYTOMA
•UNILATERAL
•SOFT TISSUE MASS 3-12 CM IN DIAMETER
•HEMORRHAGE AND NECROSIS ARE COMMON
•CALCIFICATION (10 %)
•MARKED ENHANCEMENT AFTER CM
NEUROBLASTOMA
• UNILATERAL
• IRREGULER-SOFT TISSUE MASS
• PUNCTATE TO COARSE CALCIFICATION
• INVASION KIDNEY AND RETROPERITONEAL
LYMPHNODE
• EXTENSION ACROSS THE MIDLINE
OSTEOPOROSIS

“DECREASED BONE MASS WHERE THE DIS-

TURBANCE IS THE FAILURE OF THE OSTEOBLAST
TO LAY DOWN BONE MATRIX”
A. ENDOCRINE :

1. GONADS: OVARIES & TESTES

2. ADRENAL CORTEX: CUSHING’S SYNDROME, ADRENAL
ATROPHY (SENILE OSTEOPOROSIS)
3. PITUITARY : CUSHING’S SYNDROME THROUGH ADRENAL
CORTEX. ACROMEGALYPOSSIBLY THROUGH THE GONAD.
4. THYROID : HYPERTHYROIDISM
5. PANCREAS : OSTEOPOROSIS OF DM.
B. DISUSE ATROPHY : OSTEOPOROSIS DUE TO LOSS OF
STRESS STIMULUS.
C. DEFICIENCY : INADEQUATE INTAKE, ABSORPTION OR
UTILIZATION OF PROTEIN AND VITAMIN C
D. POST TRAUMATIC : ALTERATION IN BLOOD SUPPLY.
E. CONGENITAL
THANK YOU