Peer reviewed journal
Aim: In this study, we aimed to analyze the hyperprolactinemia levels and to determine the correlation of symptoms with MRI images and to optimize their health care spending.
Methods: A total of 363 patients were included in this retrospective study, which was conducted between 01.01.2019 and 01.01.2021. Hyperprolactinemia is defined as a serum prolactin level of > 33.5 ng/mL in women. Patients with normal TSH values and isolated hyperprolactinemia were included in the study. The patients were examined in 3 groups, with prolactin levels between 33.5-70 ng/mL (first group), 70-99 ng/mL (second group), and prolactin levels 100 ng/mL and above (third group). The MRI results, treatment modality, treatment outcome and the MRI results of these patients were evaluated.
Results: The number of patients included in the first group was 273/363 (75.2%), the number of patients undergoing MRI was 23/273 (8.4%), and the number of patients in whom microadenoma was determined was 2/23 (8.7%). In the 2nd group were 49/363 patients (14%), MRI had 15/273 (30%), and microadenoma 5/15 (33%). In the 3rd group were 41/363 patients (11%), MRI had 24/273 (58%), and microadenoma 15/24 (33%). Macroadenoma was determined in the 3rd group only. MRI was not cost-effective in the first group; but this group benefited most from medical treatment. Patients in the 2nd and 3rd groups were more likely to undergo detection of microadenoma on MRI and the rate of surgical treatment was higher in 3rd group. There was a statistically significant difference between groups 1 and 3 in terms of detecting microadenoma on the MRI (p < 0.001). The prolactin levels of patients with microadenoma on MRI were statistically higher than in patients with normal MRI (p = 0.003).
Conclusion: It would be more appropriate to request MRI for patients with high (> 100 ng/mL) prolactin levels. Requesting tests according to the prolactin levels of the patients will reduce the health cost.