MRI of Pituitary Gland

[flowersurfs]

Years ago I suddenly developed thyroiditis and symptoms of hypopituitary.  After my blood test went from abnormal to normal over a period of 4 years I finally convinced my doctor to order an MRI with contrast which he did.  He said that it was completely normal but that if i was still having problems he would recheck in 6 months and he did.  He told me once again that it was completely normal and that maybe I should see a therapist.  That was in 1997.

Over the years, my problems persisted.  Occasional hypothyroid, hyperkalemia, bradycardia, tachycardia, excessive urination, gastritis, distended abdomen, vision problems and headaches.  Weekly headaches!

A few months ago, I told my gynecologist about the distended abdomen and when she looked at it she was shocked.  Because of my history of ammenorhea and dismennorhea she immediately ordered test and requested my past medical records.

She then called to ask me what happened with my pituitary issue and had I seen an endicrinologist and I told her that i was told i didnt have a pituitary issue and she said that my MRI said it was enlarged.  She then referred me to a neurologist.  I cant get into to see him until may but in the meantime i requested a copy of my MRI from 1997.

I was wondering if anyone can tell me what this means?????  Is it normal????  It was the second one that I had so i do not have the first to compare it to but i dont understand it and my gynecologist did not want to interpret it as she is not an endicrinologist or a nuerologist.

Here is what it says:
The pituitary gland measures 1.2cm x .5cm x .8 cm and is without a significant change in size from prior examination.  The infundibulum is midline and prominent measuring approximately 4mm in ap dimension and 3mm transversely.  This is increased from prior examination.  There is uniform enhancement of the infundibulum and pituitary following contrast.  Again noted is a prominence of the left portion of the pituitary when compared to the right.

New from prior exam is circumferential rind-like enhancement of the sphenoid sinus with nonenhancing soft tissue signal noted anteriorly and to the right.  On the midline images, there is new soft tissue signal identified in the region of the clivus where previously, aerated sphenoid sinus is noted.  The patient states no  surgical intervention since prior exam.

impression:  no significant change in size or appearance of pituitary gland when compared with prior exam.  Increase in size within the proximal indundibulum, just subjacent to the optic chiasm when compared with prior exam.  
Inflammatory change with enhancement circumferntially within the sphenoid sinus as well as new mucosal thickening and possible a small air fluid level, and clinical correlation is suggested.

Is this normal????  What is the normal size of a pituitary and how much is mine enlarged???

[kkrylee]

My daughter's symptoms of transient vision loss 10-20 x's a day started 4 yrs ago at age 12.  Then last October 4th, (age 16) she had temporary peripheral vision loss along with a headache pressure at the back base of her skull.  Since then, the headache pressure has never gone away (6 mos now) and her symptoms continue to increase each week: constant nausea, transient vision loss, dizziness, low back pain, tingling/numbness in right side face and sometimes arm, flushing (redness) on right side of face, burning shooting pains sporatically in her head, and now possible absence seizures 2-3 per month. She also shown that she has Orthostatic Hypotension on the Tilt Table Test and she had a positive Babinski response on her right foot.

No meds have done anything except Levsin for the nausea.  All MRI's & MRA's of brain & cervical fine (except pituitutary which endo says is fine because of her age) (she will be 17 in June).  All blood work (hormone test, ANA test, CBC, Iron), Lyme test (western blot), heavy metal testing, EEG, Echocariogram, spinal tap FINE.  The only tests not done has been a MRI of spine and a cortisol test.

I have written to a doctor in Austin who specialized in Pituitary Glands and he has agreed to review her MRI.  I just sent it to him yesterday Priority Mail.  I hope to hear something back from him next week.  If he sees something that the others did not see on the MRI, we sill go to Houston, TX (We're just outside of New Orleans) to see him.

I also spoke with a doctor who specializes in Chiari in Austin and he has been reviewing all of her records and MRI's.  I have the CD's from all of her test.  Be sure to get those from when you have a MRI or EEG or whatever done and request all written reports from the tests also.

Also, keep notes of all that has been tested, symptoms, and meds that have been tried.

I have searched everywhere to find a normal pituitary gland on MRI for a teen and cannot find any images to compare to.  The adult normal is nothing like hers, it looks like a bean.  Hers is a big round ball.

I will put you in friend category to follow up if you find anything and if we ever get a diagnosis, I will be happy to let you know.

[flowersurfs]

Hi Kkrylee,

Thanks for the reply.  I just wish someone would tell me whats a normal size pituitary, it's driving me crazy.  I'm sure you know how I feel.  I was in my late 20's when that MRI was done.  Your daughter's look similar to mine though.  How long has she been having symptoms and are they cyclical?  Has she had hormone testing done?

[kkrylee]

I am not a doctor, only a mother of a 16 yr old with a pituitary that is 9 mm and globular  in shape (a big perfect ball on her MRI).  It is butting her optic chiasm.  Her endocrinologist stated that it was normal for a teen to have a pituitary that large, but she has numerous symptoms that have not been explained through other tests so I am now trying to have the pituitary looked at again.  

What age were you when this MRI was done?   I have my daughter's  MRI of pituitary in my photos on my personal page.