La RM per le sue caratteristiche specifiche ed uniche ha sostituito la TC nello studio della patologia ipofisaria in genere e dei microadenomi in particolare. La RM consente infatti nella pressoche totalità dei casi di accertare la presenza di un microadenoma di cui inoltre ne consente un agevole monitoraggio in corso di terapia medica e dopo terapia chirurgica.
La diagnostica RM dei microadenomi si avvale dell'impiego combinato di sequenze T2 e T1 prima e dopo mdc e di sequenze dinamiche in corso di iniezione di mdc: l'accertamento di microadenoma è in funzione della presenza di segni RM diretti ed indiretti. Nei rari casi per i quali la diagnostica RM non consente una diagnosi sicura e specie se esiste il sospetto di adenomi a secrezione ACTH è indicato il ricorso al cateterismo dei seni petrosi. La TC potrebbe essere utilizzata esclusivamente nei casi che per differenti ragioni non possono giovarsi dell'impiego della RM.
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