Hyperprolactinemia, Prolactinoma: Diagnostic Tests

Obligatory 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 directions in T2 and T1 weighting with and without contrast medium.
    • MRI can be used to visualize even the smallest changes in the pituitary gland (e.g., mircoadenomas)
    • CT is now only indicated in exceptional cases, e.g., in the question of calcifications or in the presence of contraindications for an MRI examination.

    [small tumors are i. d. R. intrasellar (located in the sella cavity of the sphenoid body); with increasing tumor size: extension to suprasellar (above the sella cavity of the sphenoid body) with compression of the optic chiasm (optic nerve junction) or to parasellar with invasion of the cavernous sinus; tumors > 4 cm = “giant adenomas”]

Optional medical device diagnostics – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification.

  • Perimetry (visual field measurement) – if growth of the pituitary tumor 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) is suspected: to determine possible visual pathway lesions (evidence of visual field loss due to compression of the optic chiasm: bitemporal hemianopsia/visual disturbance with loss of both temporal visual fields).
  • Spermiogram (sperm examination)