pituitary MRI

Hi, I have had a bunch of abnormal bloodwork in the last few months.  My prolactin and cortisol levels were elevated which neccessitated at brain MRI specific to the pituitary.  I had a brain MRI 5 years ago which showed a "prominant pituitary" but normal given my age (33 at the time).  This most recent one showed no evidence of tumor or lesion....the only thing that was unclear to me is the report said "superior convex border"  The rest of the report said everything was normal (stalk midline etc).  Both my Endo and PCP call this a normal MRI.  My prolactin level has returned to normal (they are questioning it being drug related as I was taking reglan PRN and had been on Prozac 10mg for 6 days prior.  After all meds stopped levels returned to normal.   My cortisol level was mildly elevated on 24 hour urine and then I did an overnight dex test and I suppressed.  I followed up sith one more 24 hour urine and this was was well within the normal range.

What does a superior convex border on the pituitary mean?  
Thank You!

[Sumer K Sethi, MD]

Normally pituitary gland has a concvave upper margin and increase in size leads to a convex margin, in your case gland is mildly bulky but this is a case normally in the reporductive age group females and there was no focal lesion on Contrast ehanced study i suppose. So there is nothing to worry about as of now...

The configuration of the pituitary gland is influenced by age and sex, the location of the carotid arteries, the shape of the pituitary fossa, transmission of cerebrospinal fluid pulsation into the sella turcica permitted by an incompetent diaphragma sella, and the presence of an intrasellar mass. A convex contour of the superior surface of the pituitary gland was once considered to be unusual or abnormal  
(However), recent studies using CT or MRI scanning found that convex superior contours occur in as many as 35% to 44% of women of childbearing age .

[sue3708]

Thank you...this truly will let my mind rest.