jalal jalal shokouhi-m.d. isr and cirad president, jaam e jam and koorosh medical centers...

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Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers [email protected] www.medimage.ir +98 9121137884 Darioush Etemadi-M.D. Koorosh medical center Click here to email me: [email protected] Visit my webpage by clicking here: www.medimage.ir

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Page 1: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers

[email protected] www.medimage.ir

+98 9121137884

Darioush Etemadi-M.D. Koorosh medical center

Click here to email me: [email protected]

Visit my webpage by clicking here: www.medimage.ir

Page 2: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

More than 25 years imaging of adenohypophysis reveal`s inadequate requests from clinicians .

Adenohypophysis has a special vascularity in stalk and vascular tuft located centrally. (portal system)

Two cells permit contrast media enter inside cell body and they are hepatocyte and pitucyte. Any cell other than these two cells are not enhanced during dynamic injection of I.V contrast (microadenoma in adenohypophysis and metastasis in liver.)

We should mention all clinical physicians there is no value for diagnosis of microadenoma by no-contrasted pituitary gland imaging (CT and MRI). Both adenohypophysis and liver have portal system in circulation.

Page 3: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

25 years imaging of pituitary gland with inadequate requests from clinicians

Page 4: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

Adenopophysis has special vascularity in stalk and terminal tuft as a portal venous system.

Page 5: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

Two cells that contrast media goes inside that:

1. Hepatocyte

2. Pituicytethey permit contrast media enter inside cell body

Page 6: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

Cells other than these two are not enhanced during dynamic pass of contrast media.

Like microadenoma in adenohypophysis and metastasis in liver parenchyma.

Page 7: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

Non-contrasted imaging in adenohypophysis imaging is an error that many clinician do it.

Page 8: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

Microadenoma dynamic hypophysis

Page 9: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

Hemorrhagic microadenoma T1 without GD

Page 10: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

Coronal microadenoma without GD

Page 11: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

- GD Dynamic

DynamicDynamic

Page 12: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com
Page 13: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com
Page 14: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com
Page 15: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

macroadenoma

Page 16: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com

http://www.thebarrow.org/Neurological_Services/Pituitary_Center/220146

http://radiopaedia.org/articles/pituitary-microadenoma http://www.radiologyassistant.nl/en/p485d7745cc720/sella-turcica-a

nd-parasellar-region.html http://www.ijri.org/article.asp?issn=0971-

3026;year=2001;volume=11;issue=4;spage=185;epage=190;aulast=Indrajit

http://emedicine.medscape.com/article/343207-overview http://orbi.ulg.ac.be//bitstream/2268/3683/1/Pituitary

%20microadenomas.pdf http://www.sciencedirect.com/science/article/pii/

S0344033888800049 http://link.springer.com/chapter/10.1007%2F978-3-642-76450-9_34

Page 17: Jalal Jalal Shokouhi-M.D. ISR and CIRAD president, Jaam e jam and Koorosh medical centers jalaljalalshokouhi@hotmail.comjalaljalalshokouhi@hotmail.com