Sphenoid sinus mucosal thickening" plus the "pituitary ring sign" together are pathognomonic for pituitary apoplexy

Pituitary apoplexy is due to acute infarction or hemorrhage of a pituitary gland. Two MRI signs of pituitary apoplexy are the 'pituitary ring sign' and 'sphenoid sinus mucosal thickening', the former unique only to ischemic type and the later in both types. Each sign alone may exist in patients without pituitary apoplexy. However, in the appropriate clinical context, each is a strong predictor of pituitary apoplexy. To the best of my knowledge, these 2 MRI signs have never been correlated with one another in the setting of pituitary apoplexy.