Delecourt F, Leclerc X, Ardaens Y, Pruvo J P, Clarisse J, Fossati P, Dewailly D
Service d'Endocrinologie et de Diabétologie, Centre Hospitalier et Universitaire, Lille.
Ann Endocrinol (Paris). 1993;54(6):413-20.
Thirty three hyperprolactinemic women, aged 16-46 years, have been investigated by pituitary CT and MRI scans, searching for a microadenoma. The MRI scan with Gadolinium injection (MRI G+) appeared more efficient than the CT scan to detect a picture highly suggestive of a microprolactinoma (30/33 positive scans vs 21/33, respectively, p = 0.06). However, when the CT scan was performed optimaly (i.e. thin cuts, sequential imaging after iode injection, no artefact), its diagnostic potenty was close to the one of MRI G+, missing only 17.6% of lesions. All these were less than 5 mm in diameter. The indirect signs of microadenoma (focal convexity of the superior surface of pituitary, tilting of pituitary stalk, focal sella floor erosion or destruction) had a minimal value. Their sensitivity was 66.6% and 63.3 for convexity, and 63.3 and 46.6% for tilting of pituitary stalk, by MRI and CT scans, respectively. Therefore, they did not afford any help in our experience. Considering the cost and the limited accessibility of MRI, at least in our country, we advise to use CT scan as the primary morphologic means to detect a microadenoma.
对33名年龄在16至46岁之间的高催乳素血症女性进行了垂体CT和MRI扫描，以寻找微腺瘤。注射钆剂后的MRI扫描（MRI G+）在检测高度提示微催乳素瘤的图像方面似乎比CT扫描更有效（分别为30/33例阳性扫描和21/33例，p = 0.06）。然而，当CT扫描以最佳方式进行时（即薄层扫描、注射碘剂后连续成像、无伪影），其诊断效能接近MRI G+，仅漏诊17.6%的病变。所有这些病变直径均小于5毫米。微腺瘤的间接征象（垂体上表面局灶性凸起、垂体柄倾斜、鞍底局灶性侵蚀或破坏）价值极小。通过MRI和CT扫描，它们对于凸起的敏感性分别为66.6%和63.3%，对于垂体柄倾斜的敏感性分别为63.3%和46.6%。因此，根据我们的经验，它们并无帮助。考虑到MRI的成本以及至少在我国其可及性有限，我们建议将CT扫描作为检测微腺瘤的主要形态学手段。
