Preliminary Diagnosis: Pituitary Tumor

I. What imaging technique is first-line for a pituitary tumor?

MRI with contrast and with dynamic phase imaging is the first line modality.

II. Describe the advantages and disadvantages of this technique for diagnosing a pituitary tumor.

Advantages

  • Diagnostic in the appropriate clinical setting.

  • Can localize the exact area of anatomic abnormality better than any other modality.

    Continue Reading

  • Can evaluate the extent of tumor local invasion in case of pituitary macroadenoma.

  • Does not utilize ionizing radiation.

Disadvantages

  • Expensive.

  • Time consuming.

  • Requires significant patient cooperation to minimize motion artifact.

  • Patients with severe claustrophobia may require sedation.

III. What are the contraindications for the first-line imaging technique?

  • Patients with poor renal function (i.e., GFR < 30) cannot undergo MR contrasted study.

  • Patients with non-MR compatible metals and foreign bodies cannot be scanned.

IV. What alternative imaging techniques are available?

CT with contrast

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing a pituitary tumor.

CT with contrast
Advantages

  • Quick and inexpensive.

  • Can accurately demonstrate both a small adenoma and large macroadenoma.

  • Requires less patient cooperation and is less susceptible to motion artifact.

Disadvantages

  • Does not provide same level of anatomic detail as MRI.

  • Not as sensitive at detecting microadenomas as MRI.

  • Exposes the patient to ionizing radiation.

VI. What are the contraindications for the alternative imaging techniques?

CT with contrast

  • Contraindicated for pregnant patients.

  • Relative contraindication in patients with contrast allergy.

  • Relative contraindication in patients with renal failure.

Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.

No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.

Jump to Section