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Pituitary incidentalomas are pituitary tumors that are characterized as an incidental finding. They are often discovered by computed tomography (CT) or magnetic resonance imaging (MRI), performed in the evaluation of unrelated medical conditions such as suspected head trauma , in cancer staging or in the evaluation of nonspecific symptoms such ...
Many pituitary tumors (25%) are found to have areas of hemorrhagic infarction on MRI scans, but apoplexy is not said to exist unless it is accompanied by symptoms. [ 1 ] [ 4 ] In some instances, lumbar puncture may be required if there is a suspicion that the symptoms might be caused by other problems ( meningitis or subarachnoid hemorrhage ).
A prolactinoma is a tumor of the pituitary gland that produces the hormone prolactin.It is the most common type of functioning pituitary tumor. [1] Symptoms of prolactinoma are due to abnormally high levels of prolactin in the blood (hyperprolactinemia), or due to pressure of the tumor on surrounding brain tissue and/or the optic nerves.
The first MR images of a human brain were obtained in 1978 by two groups of researchers at EMI Laboratories led by Ian Robert Young and Hugh Clow. [1] In 1986, Charles L. Dumoulin and Howard R. Hart at General Electric developed MR angiography, [2] and Denis Le Bihan obtained the first images and later patented diffusion MRI. [3]
A CT or MRI of the pituitary may also show the ACTH-secreting tumor if present. However, in 40% of Cushing's disease patients MRI is unable to detect a tumor. [8] In one study of 261 patients with confirmed pituitary Cushing's disease, only 48% of pituitary lesions were identified using MRI prior to surgery.
Visual fields associated with chiasmal syndrome usually leads to an MRI. Contrast can delineate arterial aneurysms and will enhance most intrinsic chiasmal lesions. [1] If a mass is confirmed on MRI, an endocrine panel can help determine if a pituitary adenoma is involved.
Other hormone-secreting cells of the pituitary undergo rapid growth in pregnant women as well, which contribute to the gland's enlargement. [10] The anterior pituitary is supplied by a low pressure portal venous system. [15] The anterior pituitary is more commonly affected in Sheehan's syndrome because of the structure of the portal venous system.
Computed Tomography (CT scan) is another indicator of abnormalities in pituitary gland size; it also gives an image of the pituitary, but is less sensitive than the MRI. [43] In addition to assessing the size of the pituitary tumor, physicians also look for damage to surrounding tissues, and perform tests to assess whether production of other ...