Evaluation of three-dimensional MRI exploration of prolactin-secreting microadenomas

J Neuroradiol. 1993 Dec;20(4):213-25.
[Article in English, French]

Abstract

Over an 8-month period (July 1990-to February 1991), we explored 21 women presenting with a clinical and laboratory profile of prolactin-secreting microadenoma of the pituitary gland. Magnetic resonance imaging (MRI) is undoubtedly the most efficient method to explore microadenomas, especially when carried out in the absence of any treatment. In 8 cases, MRI was performed in the absence of medical treatment and gave a positive result, i.e. always showed a focal lesion. In the remaining 13 cases the patients had been treated before the exploration, and MRI detected a microadenoma in only 4 cases. The duration of treatment and the time elapsed between its withdrawal and the MRI examination did not seem to influence the positivity or negativity of the imaging results. Among the 9 cases where MRI failed to show a focal lesion, the image was normal in 3 cases and displayed an arachnoidocele in 3 cases; the pituitary gland was convex and homogeneous in 1 case and convex and heterogenous in 3 cases, which raised the problem of the effects of bromocriptine on the MRI images. As regards signals, in 5 cases the microadenoma was hyperintense on the spin-echo sequence without contrast injection; it was undetectable on the same sequence in 2 cases. In 4 cases the lesion was contrast-enhanced after gadolinium injection. Using millimetric sections enables small-size adenomas (2.5 x 3 mm) to be visualized.

MeSH terms

  • Adolescent
  • Adult
  • Arachnoid / pathology
  • Bromocriptine / therapeutic use
  • Contrast Media
  • Diagnosis, Differential
  • Evaluation Studies as Topic
  • Female
  • Follow-Up Studies
  • Gadolinium
  • Humans
  • Image Enhancement
  • Magnetic Resonance Imaging / methods*
  • Middle Aged
  • Pituitary Neoplasms / blood
  • Pituitary Neoplasms / diagnosis*
  • Pituitary Neoplasms / drug therapy
  • Pituitary Neoplasms / pathology
  • Prolactin / blood
  • Prolactinoma / blood
  • Prolactinoma / diagnosis*
  • Prolactinoma / drug therapy
  • Prolactinoma / pathology

Substances

  • Contrast Media
  • Bromocriptine
  • Prolactin
  • Gadolinium