Prolactinoma MRI: Difference between revisions

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Latest revision as of 23:49, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2], Faizan Sheraz, M.D. [3]

Overview

MRI may be diagnostic of prolactinoma. Magnetic resonance imaging (MRI) is the most sensitive test for detecting pituitary tumors and determining their size.

Key MRI findings in prolactinoma

MRI may be diagnostic of prolactinoma. Magnetic resonance imaging (MRI) is the most sensitive test for detecting pituitary tumors and determining their size. Contrast enhanced MRIs have a sensitivity of 90%. Findings on MRI scans suggestive of prolactinoma include:^[1]

Isotense to normal pituiatry on T1-weighted images.
A rounded region of delayed enhancement compared to the rest of the gland is observed on dynamic sequence post gadolinium enhancement.
Variable characteristics are found in delayed images post gadolinum enhancement. Hypo-enhancement (compared to rest of gland) is observed most commonly. Iso-intense (same as rest of gland) and hyperintense (retained contrast) is found rest of the time.
Variable, but often a little hyperintense to normal pituitary are found on T2-weighted images.

MRI examples of Prolactinoma

Coronal T1 contrast enhanced MRI showing microadenoma - Source: Radiopedia

Saggital T1 contrast enhanced MRI showing macroadenoma - Source: Radiopedia

References

↑ "Pituitary microadenoma | Radiology Reference Article | Radiopaedia.org".

Template:WikiDoc Sources

[urlPituitary_microadenoma_|_Radiology_Reference_Article_|_Radiopaedia.org-1] "Pituitary microadenoma | Radiology Reference Article | Radiopaedia.org".

[1]

@@ Line 1: / Line 1: @@
-<
 __NOTOC__
 {{Prolactinoma}}
-{{CMG}} {{AE}}{{Faizan}}
+{{CMG}};{{AE}}{{Anmol}}, {{Faizan}}
 ==Overview==
+[[MRI]] may be diagnostic of [[prolactinoma]]. [[Magnetic resonance imaging]] ([[MRI]]) is the most sensitive test for detecting [[pituitary tumors]] and determining their size.
+==Key MRI findings in prolactinoma==
+[[MRI]] may be diagnostic of [[prolactinoma]]. Magnetic resonance imaging ([[MRI]]) is the most [[Sensitivity (test)|sensitive]] test for detecting [[pituitary tumors]] and determining their size. Contrast enhanced [[Magnetic resonance imaging|MRIs]] have a [[Sensitivity (tests)|sensitivity]] of 90%. Findings on [[Magnetic resonance imaging|MRI]] scans suggestive of prolactinoma include:<ref name="urlPituitary microadenoma | Radiology Reference Article | Radiopaedia.org">{{cite web |url=https://radiopaedia.org/articles/pituitary-microadenoma |title=Pituitary microadenoma &#124; Radiology Reference Article &#124; Radiopaedia.org |format= |work= |accessdate=}}</ref>
+* Isotense to normal pituiatry on T1-weighted images.
+* A rounded region of delayed enhancement compared to the rest of the gland is observed on dynamic sequence post gadolinium enhancement.
+* Variable characteristics are found in delayed images post gadolinum enhancement. Hypo-enhancement (compared to rest of gland) is observed most commonly. Iso-intense (same as rest of gland) and hyperintense (retained contrast) is found rest of the time.
+* Variable, but often a little hyperintense to normal pituitary are found on T2-weighted images.
-Magnetic resonance imaging ([[MRI]]), is the most sensitive test for detecting pituitary tumors and determining their size. [[MRI]] scans may be repeated periodically to assess tumor progression and the effects of therapy. MRI is more sensitive than CT in detecting pituitary tumors.
+==MRI examples of Prolactinoma==
+{|
-==MRI==
+|
-Magnetic resonance imaging ([[MRI]]), is the most sensitive test for detecting pituitary tumors and determining their size. [[MRI]] scans may be repeated periodically to assess tumor progression and the effects of therapy. MRI is more sensitive than CT in detecting pituitary tumors. MRI is the mainstay of imaging for pituitary microadenomas, and required dedicated pituitary sequences (thin slice, small field of view, dynamic contrast acquisition). Contrast enhanced MRIs have a sensitivity of 90%. Post contrast and especially thin section dynamic contrast enhanced imaging is an important part of a pituitary MRI and has significantly improved diagnostic accuracy. Some often subtle morphology changes can be identified on non-contrast images however. These include bulkiness of the gland on the side of the microadenoma, subtle remodelling of the floor of the sella, deviation of the pituitary infundibulum away from the adenoma.
+[[Image:Coronal T1 contrast enhanced mri image showing microadenoma.gif|800px|left|thumb|Coronal T1 contrast enhanced MRI showing microadenoma - [https://radiopaedia.org/articles/pituitary-microadenoma Source: Radiopedia]]]
-*T1: usually isointense to normal pituitary
+|-
-*T1 C+ (Gd)
+|
-**dynamic sequences demonstrate a rounded region of delayed enhancement compared to the rest of the gland
+[[Image:Saggital T1 contrast enhanced mri image showing macroadenoma 1.gif|800px|left|thumb|Saggital T1 contrast enhanced MRI showing macroadenoma - [https://radiopaedia.org/articles/pituitary-microadenoma Source: Radiopedia]]]
-**delayed images are variable, ranging from hypo-enhancement (most common) to isointense to the rest of the gland, to hyperintense (retained contrast)
+|}
-*T2: variable, but often a little hyperintense
+<br>
-An important fact of life needs to be kept in mind when reporting pituitary MRIs: small pituitary incidentalomas are relatively common, with up to 2-30% of autopsies identifying small asymptotic microadenomas.<ref>http://radiopaedia.org/articles/pituitary-microadenoma</ref>
 == References ==
 {{Reflist|2}}
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