Prolactinoma MRI: Difference between revisions

Jump to navigation Jump to search
Line 7: Line 7:
==MRI==
==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.  
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.  
*T1: usually isointense to normal pituitary
 
*T1 C+ (Gd)
===Findings on MRI scan suggestive of prolactinoma include:<ref>http://radiopaedia.org/articles/pituitary-microadenoma</ref>
**dynamic sequences demonstrate a rounded region of delayed enhancement compared to the rest of the gland
 
**delayed images are variable, ranging from hypo-enhancement (most common) to isointense to the rest of the gland, to hyperintense (retained contrast)
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
*T2: variable, but often a little hyperintense
|valign=top|
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>
|+
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|MRI Component}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Features}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
:T1​
| style="padding: 5px 5px; background: #F5F5F5;" |
*usually isointense to normal pituitary
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:T1 C+ (Gd)
| style="padding: 5px 5px; background: #F5F5F5;" |
*dynamic sequences demonstrate a rounded region of delayed enhancement compared to the rest of the gland
*delayed images are variable, ranging from hypo-enhancement (most common) to isointense to the rest of the gland, to hyperintense (retained contrast)
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:T2
| style="padding: 5px 5px; background: #F5F5F5;" |
*variable, but often a little hyperintense
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
 
|}


== References ==
== References ==

Revision as of 17:31, 10 September 2015

Prolactinoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Prolactinoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

ECG

X-ray

Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Prolactinoma MRI On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Prolactinoma MRI

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Prolactinoma MRI

CDC on Prolactinoma MRI

Prolactinoma MRI in the news

Blogs on Prolactinoma MRI

Directions to Hospitals Treating Prolactinoma

Risk calculators and risk factors for Prolactinoma MRI

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

Overview

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

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.

===Findings on MRI scan suggestive of prolactinoma include:[1]

MRI Component Features
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
  • 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

References


Template:WikiDoc Sources