FEMALE HYPERPROLACTINEMIA: ANALYSIS OF PRESENTATION AND DIAGNOSTIC EVALUATION. IS PITUITARY MAGNETIC RESONANCE IMAGING ALWAYS INDICATED?

Sh. Salih, Ayad; L. Halabia, Sahar

	FEMALE HYPERPROLACTINEMIA: ANALYSIS OF PRESENTATION AND DIAGNOSTIC EVALUATION. IS PITUITARY MAGNETIC RESONANCE IMAGING ALWAYS INDICATED?
IRAQI JOURNAL OF MEDICAL SCIENCES
Article 1, Volume 4, Issue 1, 2005, Pages 99-110
Authors
Ayad Sh. Salih; Sahar L. Halabia
Abstract
Background: Hyperprolactinemia (HPRL) is the most common endocrine disorder of the hypothalamic-pituitary-ovarian axis. The most important and common cause is pituitary tumor. Objectives: 1. Analysis of the presenting features. 2. Role of MRI in the diagnostic evaluation of HPRL. 3. MRI measurements and correlation between MRI findings and serum prolactin concentration (PRL) in Iraqi women. 4. Literature review and work-up for HPRL. Method: clinical assessment, basal PRL and pituitary and cranium MRI performed in a case-series study for 82 Iraqi HPRL female patients attending gynecologic clinic after excluding secondary HPRL. Results: sub-fertility, galactorrhoea and menstrual irregularities were the commonest features. MRI abnormalities found in 41.46% of the patients. 88.24% were pituitary abnormalities. Their PRL was significantly higher than those with idiopathic HPRL (p=0.03). Right pituitary adenomas were more common than the left. The pituitary gland occupied 81.73% of the sella turcica in case of pituitary hyperplasia. There was no significant correlation between adenoma size and PRL (p=077), while there was significant positive correlation between pituitary and sella areas in those with normal MRI (p=0.007) as well as those with pituitary hyperplasia (p=0.04). Conclusion: PRL of 18.5ng/ml considered as the cut-off value to perform high-resolution pituitary and cranium MRI. Primary pituitary hyperplasia may carry a risk of parasellar extension during pregnancy. There is positive correlation between pituitary and sella turcica sizes. MRI considered as the gold-standard imaging method for the pituitary while sella X-ray should be abandoned. Key words: Hyperprolactinemia, Pituitary adenoma, Pituitary hyperplasia, MR imaging, MR measurement, Iraqi
Keywords
Hyperprolactinemia; Pituitary adenoma; Pituitary hyperplasia; MR imaging; MR measurement; Iraqi

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