Note: Diagnostic imaging before laboratory evidence of the disease is not indicated!
Mandatory medical device diagnostics.
- Magnetic resonance imaging of the skull (cranial MRI or cMRI): thin-slice images of the sella turcica in coronal and sagittal slice direction in T2 and T1 weighting with and without contrast medium – if changes in the pituitary gland (hypophysis)/tumor localization are suspected.
Optional medical device diagnostics – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification.
- Sonography (ultrasound examination) of the adrenal glands – if NNR tumor (tumor of the adrenal cortex) or bilateral NNR hyperplasia (“excessive cell formation” of the adrenal cortex) is suspected.
- Computed tomography (CT; sectional imaging procedure (X-ray images from different directions with computer-based evaluation)) or magnetic resonance imaging (MRI; computer-assisted sectional imaging procedure (using magnetic fields, that is, without X-rays)) of the adrenal glands – on suspicion of NNR tumor (adrenocortical tumor) or bilateral NNR hyperplasia.
- Bilateral (bilateral) catheterization of the inferior petrosal sinus – in Cushing’s disease.
- Octreotide scintigraphy – in suspected ectopic ACTH– or CRH-producing tumor.
- Perimetry (visual field measurement) – when growth of a pituitary tumor is suspected beyond the sella turcica (Turk’s saddle; bony depression of the skull base at the level of the nose and in the middle of the skull): to determine possible visual pathway lesions (detection of visual field loss due to compression of the optic chiasm: bitemporal hemianopsia/visual disturbance with loss of both temporal visual fields).
