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MRI--diagnostic and follow-up tool for microprolactinomas
Z Seidl1, J Obenberger, J Marek
1Department of Neurology, Charles University, Prague, Czech Republic.
Abstract:
Magnetic resonance imaging is a method of choice for the diagnosis of microprolactinomas. Using a Phillips Gyroscan NT 15 (1.5 T), 42 patients whose clinical history and serum prolactin levels were compatible with the diagnosis of prolactinomas were examined. Four patients (3 male and 1 female) with macroadenoma were investigated and excluded, while microprolactinoma was found in the other 38 (32 female and 6 male) patients. Imaging features were similar in all microprolactinomas--hypointensity up to 10 mm in size in T1 weighted images, only sometimes, in the case of a cystic or a hemorrhagic component, also registered in T2 weighted images. Deviation of the pituitary stalk was present in 19 of the 38 patients (16 with microprolactinoma, 3 without any detectable lesion). Convex upper limit of the gland was demonstrated in 17 subjects (16 microprolactinomas, 1 without detectable lesion). Pituitary adenoma is not the only cause of raised serum prolactin level. This can be a consequence of medication, spinal cord tumor, compression of the pituitary stalk, hypothyroidism or a lesion in dermatomes T3 to T5 (mammary gland level). Results from imaging must always be assessed in the light of the patient's clinical history and biochemical parameters.
Insights
Magnetic resonance imaging effectively diagnoses microprolactinomas, small pituitary tumors. Imaging reveals characteristic hypointensity on T1-weighted scans, aiding diagnosis when combined with clinical data.
Area of Science:
- Radiology
- Endocrinology
- Neuroimaging
Background:
- Microprolactinomas are small pituitary tumors often diagnosed using Magnetic Resonance Imaging (MRI).
- Elevated serum prolactin levels can indicate pituitary adenoma but also other conditions.
- Accurate diagnosis requires integrating imaging findings with clinical and biochemical data.
Purpose of the Study:
- To evaluate the utility of MRI in diagnosing microprolactinomas.
- To describe the characteristic MRI features of microprolactinomas.
- To differentiate microprolactinomas from other causes of hyperprolactinemia.
Main Methods:
- A Phillips Gyroscan NT 15 (1.5 T) MRI scanner was used.
- 42 patients with clinical suspicion of prolactinoma underwent MRI examination.
- Imaging findings were analyzed in correlation with serum prolactin levels and clinical history.
Main Results:
- Microprolactinomas were identified in 38 patients (32 female, 6 male).
- Characteristic MRI findings included hypointensity on T1-weighted images (up to 10 mm).
- Pituitary stalk deviation and a convex upper gland limit were observed in a subset of patients.
Conclusions:
- MRI is a valuable tool for diagnosing microprolactinomas.
- Specific imaging features aid in identifying these small pituitary tumors.
- Differential diagnosis of hyperprolactinemia must consider non-adenoma causes alongside imaging results.
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