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Analysis of indirect signs of microprolactinoma at MR imaging
1Department of Radiology, Hospital Universitario Reina Sofia, Córdoba, Spain. acano@sofia.hrs.sas.cica.es
Objective:
To evaluate the diagnostic reliability/value of microprolactinoma indirect signs at MRI.
Methods And Material:
A prospective study was carried out over 3 years on 26 women with microprolactinoma (MiP group) and 106 healthy female volunteers as a control group. Size, glandular morphology, pituitary stalk inclination and sellar bony floor erosion were measured and a comparative statistical analysis between both groups was performed.
Results:
Patients from the MiP group showed a significantly bigger glandular size than women in the control group, although the glandular morphology did not present significant differences between both groups. Only 5% of normal glands measured over 7.5 mm in height and none of them reached 9 mm, while up to 42.3% of the MiP group scored over 7.5 mm and 19.2% over 9 mm. Mean stalk inclination for the MiP group was 4.6 +/- 3.1 degrees and 3.5 +/- 2.7 degrees for the control group with no significant differences. Five microprolactinomas were located on the glandular midline, 11 on the left side and ten on the right side. No relationship between the microadenoma location inside the gland and stalk inclination was found. From 21 microprolactinomas with eccentric location, 17 coincided with the sellar floor excavation; eccentric excavation presented significant differences between both groups, but not the central excavation.
Conclusion:
From all indirect sings of microprolactinoma analyzed in this study, only a gland height over 9 mm, and an eccentric sellar excavation of at least 3 mm are reliable signs to support its diagnosis.
Insights
Magnetic resonance imaging (MRI) can reliably diagnose microprolactinomas using specific indirect signs. A pituitary gland height over 9 mm and eccentric sellar excavation of at least 3 mm are key indicators.
Area of Science:
- Radiology and Imaging
- Endocrinology
- Neurosurgery
Background:
- Microprolactinomas are small pituitary tumors that secrete prolactin.
- Accurate diagnosis of microprolactinomas is crucial for appropriate management.
- Indirect MRI signs may aid in the diagnosis of microprolactinomas.
Purpose of the Study:
- To evaluate the diagnostic reliability and value of indirect MRI signs for microprolactinoma.
- To identify specific MRI features that can support the diagnosis of microprolactinoma.
Main Methods:
- Prospective study over 3 years involving 26 women with microprolactinoma and 106 healthy controls.
- Measurement of pituitary gland size, morphology, stalk inclination, and sellar floor erosion via MRI.
- Comparative statistical analysis between the microprolactinoma and control groups.
Main Results:
- Microprolactinoma patients showed significantly larger pituitary gland height compared to controls.
- Glandular morphology did not differ significantly between groups.
- A gland height over 9 mm was observed in 19.2% of microprolactinoma patients versus 0% of controls.
- Eccentric sellar excavation (≥3 mm) was significantly more frequent in microprolactinoma patients.
Conclusions:
- Pituitary gland height exceeding 9 mm is a reliable indirect MRI sign for microprolactinoma.
- Eccentric sellar excavation of at least 3 mm is another reliable indirect sign supporting microprolactinoma diagnosis.
- These specific indirect signs enhance the diagnostic accuracy of MRI for microprolactinomas.