The (My) Golden Rules

The knowledge of medical history and hormonal status is of uppermost importance when a pituitary MRI is prescribed. For instance, the term “hyperprolactinemia” can be misleading, what matters is the exact prolactin level. The choice of sequences depends on these information and on the precise suspected diagnosis. There is no “standard pituitary MRI protocol”. The T2W sequence is frequently the most informative. Gadolinium injection must not be systematic and can be spared in several conditions, such as after surgery or for follow-up. Dynamic MRI is rarely useful and can be tricky. It has to be reserved for exceptional conditions or for research purpose.