Prolactin-Secreting Pituitary Microadenomas: Inaccuracy of High-Resolution CT Imaging

Abstract

Computed tomographic (CT) and surgical findings were correlated retrospectively in 51 patients with preoperative diagnoses of prolactin-secreting pituitary microadenomas. Twenty-four had microadenomas at surgery. Twenty-eight had identifiable discrete lesions. Of these, 18 had microadenomas and 10 did not; these two groups could not be distinguished reliably. Six patients with proven microadenomas had normal CT scans. Focal hypodense lesions, sellar floor erosion, infundibulum displacement, gland height greater than 8 mm, and an abnormal diaphragma sellae configuration are neither sensitive nor specific findings of microadenoma. A significant number of patients with proven microadenomas had few or none of these abnormalities. Thus, recognition of prolactin microadenoma is seldom possible by CT alone, even with high-resolution direct coronal imaging.