MRI of the pituitary gland with contrast is a magnetic resonance examination of the most important endocrine gland of the human body, due to its small size, the use of contrast agents is required. Contrast agents for MRI contain nanoparticles of gadolinium, a metal that can increase the sensitivity and information content of the method. Once in the blood, gadolinium is evenly distributed throughout all tissues of the human body. Inflammatory processes, tumors and other anomalies, on the contrary, lead to local accumulation of contrast, which is why this area stands out in the images, facilitating diagnosis.
Where is the pituitary gland located?
The pituitary gland is the most important organ of the endocrine system (gland), which produces a number of biologically active substances (hormones) that regulate the balance of energy, nutrients and minerals, cell division, sexual functions and reproduction, metabolism and many other aspects of the normal functioning of the human body. This is hard to believe, especially considering the small size of the pituitary gland - only 13 mm in length, 5-6 mm in thickness (the size of a pea or bean). The mass of the pituitary gland does not exceed 0.5 grams.
The pituitary gland is located at the base of the brain, inside the skull, in an area called the sella turcica (due to the shape of the bones, which actually resemble a saddle). The only method for diagnosing pituitary gland diseases that allows obtaining detailed and high-quality images is magnetic resonance imaging. MRI of the pituitary gland is always performed with contrast - this allows to increase the accuracy of diagnosis and the information content of the images, which is important, given the miniature size of the organ.
How often can I have a head MRI?
Magnetic resonance imaging is safe for the health of patients; the number of procedures is determined by the doctor. The frequency of head MRI depends on the clinical picture and the disease being diagnosed:
- hydrocephalus requires scanning every 5 years, if necessary, dynamic monitoring is carried out, the frequency of which is determined by the attending physician;
- neoplasms are scanned up to 4 times during the first year, then 1-2 times a year if there is no tumor growth;
- for multiple sclerosis, examinations are prescribed 1-2 times a year;
- stroke - an MRI is performed to establish a diagnosis, then sent for preventive examinations every 4 years;
- Alzheimer's disease - a one-time scan is recommended to confirm the nature of the pathology;
- To monitor recovery processes after surgery, 3-4 procedures are carried out during the first year; in the future, the frequency of MRI depends on the clinical picture.
Alzheimer's disease on MRI
Scanning the brain with a magnet does not carry radiation exposure and does not have a negative effect on organs and tissues. The noise and the need to lie still during the entire examination create some inconvenience, but in general the method is painless and comfortable for the patient.
Indications and contraindications for MRI of the pituitary gland with contrast
Indications for the use of contrast-enhanced MRI of the pituitary gland:
- pituitary tumors/cysts of various origins;
- metastases to the pituitary gland;
- empty sella syndrome;
- hypofunction of the pituitary gland (decrease in the levels of pituitary hormones - prolactin, somatotropin, TSH, LH, FSH, etc.);
- hyperfunction of the pituitary gland (increased levels of pituitary hormones);
- apoplexy (hemorrhage) in the pituitary gland, pituitary necrosis (Sheehan syndrome);
- Itsenko-Cushing's disease;
- other endocrine disorders associated with the functional activity of the pituitary gland.
Symptoms in which an MRI of the pituitary gland is recommended:
- headache;
- decreased visual acuity (loss of visual fields, double vision, distortion of visible objects);
- excessively short or high stature inappropriate for age, delayed physical development;
- constant thirst with increased fluid consumption and frequent urination;
- infertility, both male and female;
- impotence in men, irregularities or absence of the menstrual cycle in women;
- obesity.
Is contrast necessary for MRI of the pituitary gland?
Contrast during MRI of the pituitary gland is used in the vast majority of cases.
Due to the small size of the organ, conventional MRI images are not very informative. The only exception is an MRI of the pituitary gland with an already established diagnosis of macroadenoma, when it is necessary to evaluate the dynamics.
Contrast enhancement makes it possible to see all the structures of the pituitary gland, and in the presence of adenomas, to consider their size, location and possible growth into neighboring brain tissue.
For contrast, gadolinium-based drugs are used, which are well tolerated and harmless to the patient.
Contraindications to contrast-enhanced MRI of the pituitary gland
MRI of the pituitary gland with contrast is contraindicated:
- patients who have metal foreign bodies in their bodies (iron filings in the eyes, steel clips on blood vessels, orthopedic structures, etc.) – the metal heats up and can move from its place under the influence of magnetic fields;
- patients with pacemakers, defibrillators, neurostimulators, cochlear implants, insulin pumps - magnetic fields can damage complex electronics;
- pregnant women in the first 13 weeks of pregnancy - MRI is not recommended in the first trimester of pregnancy without good reason;
- children under 5 years of age - MRI in children under 5 years of age is performed in specialized hospitals under anesthesia and medical supervision;
- patients with severe claustrophobia - people with a fear of closed spaces often cannot remain calm and still during an MRI examination.
In addition, MRI diagnostics may be hampered by excess weight (more than 130 kg) and circumference (more than 150 cm in girth) of the body. Patients with such data do not physically fit in the magnetic resonance imaging machine.
What determines the price of an MRI?
The power of the tomograph The higher the induction level of the device, the more expensive tomography will cost you. Therefore, before doing an MRI, be sure to consult about the best power of the device to choose.
Promotions and discounts Pay attention to promotions at night. Night discounts usually start from 23.00 to 7.00. The cost reduction reaches 30% of the daily price.
Doctor's qualifications
It is the medical examination of the radiologist that guarantees the success and quality of interpretation of MRI images.
Use of contrast Native MRI costs almost half as much as contrast MRI, since contrasting adds the cost of a contrast composition, calculated based on the patient’s body weight.
The price of MRI of the pituitary gland in medical centers in St. Petersburg includes: direct diagnosis, preparation and interpretation of the results, free consultation with a doctor and recording of the results on an electronic medium.
| Service | Price according to Price | Discount Price at Night | Discount Price During the Day |
| from 23.00 to 8.00 | from 8.00 to 23.00 | ||
| MRI of the brain | 3300 rub. | 2690 rub. | 2990 rub. |
| MRI of cerebral vessels (arteries) / MR angiography of cerebral vessels | 3300 rub. | 2690 rub. | 2990 rub. |
| MRI of the brain and cerebral vessels | 6600 rub. | 5380 rub. | 5980 rub. |
| MRI of the pituitary gland (without contrast) | 3500 rub. | 2690 rub. | 2990 rub. |
| MRI of the pituitary gland with contrast | from 6500 rub. | not implemented | from 6900 rub. |
| MRI of the pituitary gland and brain | 7800 rub. | 5380 rub. | 5980 rub. |
| MRI of the central nervous system (MRI of the brain, MRI of the cervical, thoracic and lumbosacral region) | 13200 rub. | 9590 rub. | 10890 rub. |
| Comprehensive head diagnostics (MRI of the brain, MRI of cerebral vessels, ultrasound of neck vessels, consultation with a neurologist) | 10900 rub. | 7500 rub. | |
| Contrast administration (based on patient weight) | from 4000 to 6000 rub. | from 4000 to 6000 rub. |
Preparing for MRI of the pituitary gland with contrast
Magnetic resonance imaging of the pituitary gland with contrast agents is performed without any preliminary preparation. The study can be carried out at any time convenient for the patient. The main condition for safe MRI is the absence of foreign metal objects on the patient’s body. Magnetic fields generated during the examination can lead to heating of jewelry, piercings, and metal clothing fittings, with the risk of burns. It is strictly prohibited to carry mobile phones, electronic gadgets, credit and other magnetic cards, storage media, external batteries, etc. Otherwise, injury or burns may occur. The patient can leave anything unnecessary in the storage room.
Contrast drugs very rarely cause side effects - the most common of them is a mild allergy in the form of a small rash and itching on the skin. Severe allergic reactions to contrast are rare and also serve as a contraindication for its administration. In such cases, the study is performed without contrast.
Features of MRI of the pituitary gland
Screening of the pituitary gland is usually performed using closed-type tomographs with a power of 1 Tesla or more. Such scanners are a magnet in the shape of a cylinder, inside of which a movable table with a patient is placed. Due to the technical limitations of the tomograph, the patient's body weight should be no more than 150 kg.
Open-field tomographs are rarely used to diagnose organs such as the pituitary gland, since they have lower resolution. However, examination of severely obese patients, young children and those suffering from claustrophobia is only possible with open scanners.
The magnet of the MRI scanner generates a powerful constant magnetic field, and coils located inside the scanner create and send radio frequency pulses. Sensors built into the device receive return pulses, which are read by a special computer program. The program processes the received signals and generates a series of image slices no more than 1-2 mm thick. These slices provide high-resolution, three-dimensional images of the organ being scanned from different angles.
Absolute contraindications to MRI of the pituitary gland:
- implanted pacemakers and pacemakers;
- intracranial clips made of ferromagnetic materials;
- electronic cochlear devices;
- artificial heart valves and pumps;
- foreign bodies and fragments in the eye sockets;
- metal prostheses.
Absolute contraindications to MRI are due to the fact that a strong magnetic field disables electronic devices and magnetizes ferromagnets, which are displaced under the influence of a magnet. Radiofrequency waves can mimic heartbeats and nerve impulses, putting patients with implanted pacemakers, neurostimulators, and defibrillators at risk. In all of the above cases, MRI is strictly prohibited.
MRI is also contraindicated for women in the first trimester of pregnancy, since the effect of the magnetic field on the unformed fetus has not yet been studied. The second and third trimesters, lactation, menstruation, and taking oral contraceptives are not contraindications for MRI diagnostics.
How does a contrast-enhanced MRI of the pituitary gland work?
Magnetic resonance imaging is performed on an outpatient basis, using special equipment - an MRI scanner. The research setup is a large cylindrical block with a tunnel equipped with a special bed on which the patient lies during the examination. A lattice structure resembling a helmet is installed around the patient’s head - this is an additional coil that increases the quality and clarity of images of the brain and pituitary gland.
Before the examination, the patient is asked to wear special headphones - they protect the ears from the noise that occurs during the operation of the tomograph. Headphones can transmit music, which helps the patient relieve stress, and also serve to communicate with the operator. To make an emergency call to the operator, the patient can press a pear-shaped button, which is in his hands at all times during the examination.
The duration of an MRI of the pituitary gland is approximately 30 minutes. In the first half, the study is performed without contrast. Then, 15 minutes after the start of the procedure, the nurse administers an intravenous contrast agent, after which the study is repeated with contrast enhancement.
All that is required of the patient during diagnosis is to lie down, remaining calm and still. MRI is an absolutely safe and painless procedure that is not accompanied by any unpleasant sensations. Slight discomfort may occur in people prone to anxiety and panic attacks due to the limited space of the tunnel.
After completing the examination, you must wait for the images to be decrypted (usually this takes a maximum of 15-30 minutes). The images themselves are recorded free of charge on a CD and sent to the patient along with a written report from the radiologist. If desired, you can record pictures on a flash drive or print them on film.
MRI of the brain: preparation for the study
The essence of MRI is the use of a magnetic field that affects water dipoles in the body's cells. The intensity of the response directly depends on the moisture saturation of the tissues. The examination takes about 30 minutes; when using a contrast agent, the duration of the procedure increases to 45 minutes.
The patient lies down on a mobile table, his head is fixed with restraints. The magnetic field generator and sensors that read information are located in the wide part of the tomograph, which has the shape of a pipe. The table with the patient moves to the annular section of the device, where the brain is scanned in sagittal, frontal and axial projections.
To improve the quality of the examination, a gadolinium-based contrast solution is used. The drug is administered intravenously, it has no toxic effect and is eliminated from the body within 1-2 days. The contrast illuminates the vascular system of the brain and visualizes the slightest changes in the area of soft tissue, veins and arteries.
During the procedure, the tomograph creates a lot of noise, so the patient is recommended to use special headphones provided by the clinic. Communication with medical personnel is maintained using an intercom. During magnetic resonance imaging, the doctor and technicians are located in an adjacent room, separated by a partition. The data obtained as a result of the study is received on a computer monitor in the form of layer-by-layer images.
Layered MRI photographs of the brain printed on film, axial projection
A tomogram visualizes the condition of internal organs and helps diagnose the following diseases:
- neoplasms in the head area;
- vascular development abnormalities;
- pituitary diseases;
- consequences of head injuries;
- pathologies associated with impaired blood supply to the brain;
- inflammatory changes in cerebral structures and membranes, cranial nerves;
- congenital pathologies.
MRI of the brain does not require complex preparation. The patient should consult a doctor and exclude the presence of factors that are absolute contraindications to magnetic resonance imaging. These include:
- the presence in the body of the subject of metal products used for medical purposes (pins, dental crowns, implants, dentures, knitting needles, etc.);
- the presence of implanted electromagnetic devices (pacemaker, insulin pump, etc.);
- the presence on the patient’s skin of tattoos made with paints with a high metal content.
If contrast is used, the patient must warn the doctor about the tendency to allergic reactions, the presence of renal and liver failure, diseases of the cardiovascular system and other previously diagnosed pathologies. Any medications taken immediately prior to the MRI should be reported. Patients suffering from claustrophobia should also warn their doctor. A specialist will help you avoid panic attacks during the procedure.
Women are not recommended to undergo an MRI during the first trimester of pregnancy. This is due to the insufficiently studied effect of a magnet on the embryo during the formation of vital organs. Nursing mothers should express milk for the next 2 feedings, which will avoid getting gadolinium salts during contrast MRI into the baby's food.
The subject prepares for the scan in advance: removes uncomfortable clothes, jewelry, accessories, and piercings. The patient then takes a horizontal position on the table and follows the doctor’s recommendations during the procedure.
MRI of the brain in a child, images in a sagittal projection
Interpretation of the results of MRI of the pituitary gland with contrast
MRI results of the pituitary gland - a series of thin layer-by-layer images of the sella turcica area. Since the pituitary gland is the size of a pea, each section has a minimum thickness of 1 mm. The radiologist carefully examines each image, looking for deviations from the norm. Normal MRI picture of the pituitary gland: dimensions do not exceed 1-1.3 cm, absence of cysts, tumors and other heterogeneous inclusions, the anterior and posterior lobes of the pituitary gland are clearly distinguishable. When administered, the contrast is evenly distributed throughout the pituitary gland. In addition, the condition of the tissues surrounding the pituitary gland - nerve fibers, blood vessels and other anatomical structures - is described.
Local accumulation of contrast is the main sign of the presence of a pituitary tumor. Most often, doctors deal with so-called pituitary adenomas - these are hormonally active tumors that secrete pituitary hormones. An excess of certain hormones leads to endocrine diseases with corresponding symptoms.
Adenomas in the photographs look like formations in the pituitary tissue of arbitrary size, intensively accumulating a contrast agent. Moreover, in the absence of contrast, the tumor may not be visible - very small tumors or microadenomas can hardly be detected without contrast. This is why MRI of the pituitary gland is almost always performed with contrast enhancement.
Pituitary tumor on MRI
Pituitary adenoma on MRI
Most often, pituitary adenoma is detected on tomograms - a benign neoplasm emanating from the anterior lobe. Tumors can grow from any part of the pituitary gland, which causes a variety of clinical manifestations. Pituitary adenoma is localized in the area of the sella turcica; with significant growth, it can spread to the bone sinuses, ventricles of the brain, and the basal surface of the cerebral hemispheres. The doctor can view the above-described structures in the form of multiplanar volumetric images consisting of many slices, which makes it possible to clarify:
- size and boundaries of the tumor;
- its relationship with surrounding structures - suprasellar and medullary cisterns, optic chiasm, sinus of the sphenoid bone, dorsum and tubercle of the sella, cavernous sinuses, etc.;
- presumptive nature (benign or malignant, primary or metastatic, final verification is available after morphological examination). Post-contrast images are analyzed, the intensity of dye accumulation (the vast majority of adenomas retain the drug more slowly than pituitary tissue; malignant tumors are characterized by increased angiogenesis). Differentiation is carried out with craniopharyngioma, Rathke's pouch cyst and arachnoid fluid cavity, which have similar features on MR scans.
The specialist makes a conclusion about the presence of a neoplasm of the pituitary gland when detecting deformation of the bottom of the pituitary fossa, asymmetry of the gland itself, heterogeneity of its structure, and displacement of the infundibulum from the midline.
What can you eat and drink before an MRI of the brain and blood vessels?
2 days before MRI of the brain, the patient should limit the intake of fatty, fried, salty, and spicy foods. It is not advisable to overload the digestive system. Experts recommend stewed vegetables, lean meat and fish, cereals, light soups, and fresh fruits.
It is advisable to maintain a drinking regime and avoid dehydration. Drinks allowed include still water, compotes, and juices. The volume of fluid consumed on the eve of an MRI should not exceed 1.5-2 liters, which will help avoid swelling. It is recommended to eat 3 hours before the procedure; you can drink water 1 hour before the scan.
Tumors (probably craniopharyngioma) of the pituitary gland on MRI of the brain with contrast
Compliance with medical recommendations affects the quality of the study and increases the information content of the resulting images.
What should a patient take with him to an MRI?
Examinations in clinics in the northern capital are carried out as prescribed by the attending physician and at the patient’s own request. To obtain the most informative tomography results, it is necessary to provide the radiologist with as much information as possible about the current disease before the procedure. Therefore, for an appointment with a tomography room you need to take:
- extract from the medical history;
- pictures of past CT scans or results of ultrasound and other diagnostic screenings;
- referral from a doctor (if available);
- responses from all past MR screenings for dynamic assessment.
Before booking a place for an examination, it is better to obtain specific comments from the attending physician about the need for scanning with contrast or in a native format. Additionally, it is worth clarifying the device with what power to choose. This will prevent cases where the results do not bring specific answers due to an incorrectly selected diagnostic protocol and repeated tomography.
