Pituitary microadenoma – doubts about the conclusion of MRI
Question: Dear Doctor, tell us, please, your opinion about my research. After 9 months of attempts to become pregnant consult a doctor. As a result of surveys (not yet completed) found elevated prolactin 39,7 standards in 1,2-19,5. Passed on MRI exceptions mikroadenomygipofiza. That conclusion. pituitary MRI scanning technique T1-sagital, 3d T1 coronal, t1 axialna series of tomograms of the pituitary deformed by bulging of the lower and upper circuit on the right. dimensions pituitary anteroposterior 7mm, 9mm vertical (right), horizontal 14mm. precise contours of the rough. adenohypophysis heterogeneous structure due to the presence of irregularly shaped plot pathological intensity, covering the right cavernous sinus, with indistinct outlines, Homogeneous gipointensivnymi in T1 signal characteristics. neurohypophysis homogeneous structure with a hyperintense T1 signal characteristics. funnel pituitary is the middle, width 2mm. chiasma of the optic nerves is usually clear smooth contours. cavernous sinuses of both carotid arteries symmetrical, smooth contours clear. basic sinus pneumatization is not broken. parasellyarnye tank with clear smooth contours, structure without pathology signals. Conclusion: The signs of pituitary microadenomas. I have a few questions: 1. Does the description of the MRI that I have encountered microadenoma or opinion only implies? Confused, that does not specify its size. 2. Should I make an analysis of the control of prolactin on the grounds that the disorders of the menstrual cycle is not observed, and the sensations and the results of ultrasound ovulation occurs regularly.
Answer: 1. MRI non-uniformity can be a sign of pituitary adenoma, but otsutsvtie clearly defined boundaries in this case does not allow to determine the size. Elevated levels of prolactin may be associated with both a violation of the regulation of pituitary cells that produce prolactin, and with pituitary adenoma. When small amounts of adenoma treated the same as with an increase in prolactin without adenoma (receiving drugs that reduce prolactin levels – Your doctor is likely to appoint them). 2. If you're referring to the re-determination of prolactin to make sure that it really improved. . . Yes, the prolactin level may be overstated in its study (see the FAQ on the subject), you must also determine the level of makroprolaktina (biologically inactive prolactin), but if re-analysis of prolactin to be upgraded – with a fairly long-term treatment of non-occurrence of pregnancy, reduces the level of prolactin, appropriate.