Girard N, Cortesi L, Chabert-Orsini V, Maman P, Brue T, Jaquet P, Raybaud C
Service de Radiologie, Hôpital Nord, Marseille.
J Neuroradiol. 1993 Dec;20(4):213-25.
Over an 8-month period (July 1990-to February 1991), we explored 21 women presenting with a clinical and laboratory profile of prolactin-secreting microadenoma of the pituitary gland. Magnetic resonance imaging (MRI) is undoubtedly the most efficient method to explore microadenomas, especially when carried out in the absence of any treatment. In 8 cases, MRI was performed in the absence of medical treatment and gave a positive result, i.e. always showed a focal lesion. In the remaining 13 cases the patients had been treated before the exploration, and MRI detected a microadenoma in only 4 cases. The duration of treatment and the time elapsed between its withdrawal and the MRI examination did not seem to influence the positivity or negativity of the imaging results. Among the 9 cases where MRI failed to show a focal lesion, the image was normal in 3 cases and displayed an arachnoidocele in 3 cases; the pituitary gland was convex and homogeneous in 1 case and convex and heterogenous in 3 cases, which raised the problem of the effects of bromocriptine on the MRI images. As regards signals, in 5 cases the microadenoma was hyperintense on the spin-echo sequence without contrast injection; it was undetectable on the same sequence in 2 cases. In 4 cases the lesion was contrast-enhanced after gadolinium injection. Using millimetric sections enables small-size adenomas (2.5 x 3 mm) to be visualized.
在8个月期间（1990年7月至1991年2月），我们对21例具有垂体泌乳素分泌微腺瘤临床和实验室特征的女性进行了检查。磁共振成像（MRI）无疑是检查微腺瘤最有效的方法，尤其是在未进行任何治疗的情况下进行检查。8例患者在未接受药物治疗时进行了MRI检查，结果呈阳性，即始终显示有局灶性病变。其余13例患者在检查前已接受治疗，MRI仅在4例中检测到微腺瘤。治疗持续时间以及停药与MRI检查之间的时间间隔似乎并未影响成像结果的阳性或阴性。在MRI未能显示局灶性病变的9例中，图像正常的有3例，显示蛛网膜囊肿的有3例；垂体呈凸面且均匀的有1例，呈凸面且不均匀的有3例，这就提出了溴隐亭对MRI图像影响的问题。关于信号，5例微腺瘤在未注射造影剂的自旋回波序列上呈高信号；2例在相同序列上未检测到。4例病变在注射钆后有强化。使用毫米级切片能够观察到小尺寸腺瘤（2.5×3毫米）。
