[Prolactinoma: radiologic appearance of the sella turcica].

Radiologic studies of the sella turcica have been performed in 355 patients operated on for prolactinomas. According to our classification, the grading of the sella in 300 females was normal in seventeen, grade I in one hundred and seventy-eight, grade II in eighty-seven, grade III in nine and grade IV in nine. A suprasellar expansion was evidenced in twenty-four of these patients. In 55 men, the sella was of grade I in eight, grade II in thirty-nine and grade IV in eight. Twenty-three had a suprasellar expansion. The early radiological diagnosis of a prolactin-secreting microadenoma became important when the hypophyseal origin of the clinical syndromes associated with hyperprolactinemia was demonstrated. Prolactinomas can usually be diagnosed by polytomography when they have reached 4 mm in size. Subtle bony changes such as cortical thinning, lateralized blistering or bulging of the floor are reliable radiological signs when associated with a biologically confirmed clinical syndrome.