Brain Bites – Prolactinoma скачать в хорошем качестве

Brain Bites – Prolactinoma

Welcome to the latest installment in our series, Brain Bites, where we use short videos featuring other physicians and learners to neuroradiology concepts in short, easily digestible bites. Hopefully these videos will give you some quick points so that you can become more effective at evaluating brain and spine imaging. Today’s video is focused on prolactinoma and is presented by Stefani Yates, a medical student at Morehouse School of Medicine. Prolactinoma is a subset of pituitary adenomas, which are the most common masses of the sella. Non-secreting adenomas are the most common pituitary adenomas by a slight margin, although prolactin secreting tumors are the most common secreting tumors. These are divided into microadenomas (10 mm or less) or macroadenomas (larger than 10 mm). Sagittal and coronal MRI are the best way to visualize the sella. Pituitary adenomas usually enhance slower and less than the surrounding normal pituitary, so they appear darker than the surrounding pituitary. In this case, you can see hypoenhancing tumor on the right side of the screen (patient left). The differential diagnosis includes: Rathke cleft cyst – usually has a thin rim and doesn’t enhance. May have a T1 hypointense nodule Meningioma – usually more avidly enhancing, and you might see a normal adjacent pituitary. If they encase the carotid arteries, they are more likely to cause narrowing of the vessel lumen Craniopharyngioma – more heterogeneous, possibly calcified, and centered ABOVE the sella Some other tips that you might see with pituitary adenomas are invasion of the cavernous sinuses, mass effect on the optic nerves or optic chiasm. This mass effect on the optic chiasm can cause loss of peripheral visual fields. You might also see T1 hyperintensity on the pre-contrast images, which reflects methemoglobin in an area of hemorrhage within the tumor. So, remember that prolactinomas are the most common tumors of the sella. They are often accompanied by expansion of the sella, mass effect on the optic nerves, invasion of the cavernous sinus, and internal hemorrhage. Thanks for tuning in today and be sure to check out the rest of the Brain Bites Series. Check out this video and additional content on http://www.learnneuroradiology.com