The case of Cushing's disease imaging by SPECT examination without manifestation of pituitary adenoma in MRI examination.
BACKGROUND
The aim of our study was to evaluate the possibility of imaging the pathological accumulation of (99m)Tc-MIBI in the pituitary gland in patients with Cushing's disease when MRI examination does not show microadenomas.


METHODS
Cushing's disease was diagnosed in a 27 year old male on the basis of clinical and biochemical findings. The blood cortisol level of the patient was elevated (the average level was 47 ug/dl) and it showed no changeability of day and night rhythm.


RESULTS
In the patient with Cushing's disease, during the SPECT examination, an increased accumulation of (99m)Tc-MIBI in the pituitary gland was noticed. MRI scanning was negative.


CONCLUSIONS
Single photon emission computed tomography using (99m)Tc-MIBI is a useful and sensitive means of pituitary gland microadenoma detection in patients with Cushing's disease when microadenoma is not detected during MRI scanning and when the results of dexamethasone suppression test is positive.
Gierach
Marcin
M
Laboratory of Nuclear Medicine of the Department of Endocrinology and Diabetology of the Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland.
Pufal
Joanna
J
Pilecki
Stanisław
S
Junik
Roman
R
D000236:Adenoma / Q000175:diagnosis*; D000328:Adult; D003480:Cushing Syndrome / Q000175:diagnosis*; D005188:False Negative Reactions; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010911:Pituitary Neoplasms / Q000175:diagnosis*; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi