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Pediatric Radiology

, Volume 42, Issue 7, pp 799–804 | Cite as

A retrospective review of pituitary MRI findings in children on growth hormone therapy

  • Sarah L. TsaiEmail author
  • Eoghan Laffan
  • Sarah Lawrence
Original Article

Abstract

Background

Patients with congenital hypopituitarism might have the classic triad of pituitary stalk interruption syndrome, which consists of: (1) an interrupted or thin pituitary stalk, (2) an absent or ectopic posterior pituitary (EPP), and (3) anterior pituitary hypoplasia or aplasia.

Objective

To examine the relationship between pituitary anatomy and the degree of hormonal dysfunction.

Materials and methods

This study involved a retrospective review of MRI findings in all children diagnosed with congenital growth hormone deficiency from 1988 to 2010 at a tertiary-level pediatric hospital.

Results

Of the 52 MRIs reviewed in 52 children, 26 children had normal pituitary anatomy and 26 had one or more elements of the classic triad. Fourteen of fifteen children with multiple pituitary hormone deficiencies had structural anomalies on MRI. Twelve of 37 children with isolated growth hormone deficiency had an abnormal MRI.

Conclusion

Children with multiple pituitary hormone deficiencies were more likely to have the classic triad than children with isolated growth hormone deficiency. A normal MRI was the most common finding in children with isolated growth hormone deficiency.

Keywords

Pituitary MRI Hypopituitarism Congenital growth hormone deficiency Classic triad 

Notes

Acknowledgements

This work was presented at the following meetings: the Endocrine Society Meeting, June 2010, San Diego, CA, USA (poster); the Canadian Pediatric Endocrine Group Meeting, February 2011, Toronto, Canada (oral presentation); and the European Society of Pediatric Radiology Meeting, June 2010, Bordeaux, France (oral presentation).

We would like to thank Dr. Margaret Lawson for assisting with generation of research questions, Ms. Brenda Fraser, RN, for assistance with the patient database, and Dr. Jeffrey Tsai for review of manuscript.

References

  1. 1.
    Beukhof CM, Lequin MH, Drop ST (2007) The classic triad and variants. In: Deal C (ed) MRI in congenital hypopituitarism. Lilly Genesis References Series, Chicago, pp 69–80Google Scholar
  2. 2.
    Maghnie M, Triulzi F, Larizza D et al (1991) Hypothalamic-pituitary dysfunction in growth hormone-deficient patients with pituitary abnormalities. J Clin Endo Metab 73:79–83CrossRefGoogle Scholar
  3. 3.
    Abrahams JJ, Trefelner E, Boulware SD (1991) Idiopathic growth hormone deficiency: MR findings in 35 patients. AJNR 12:155–160PubMedGoogle Scholar
  4. 4.
    Hamilton J, Chitayat D, Blaser S et al (1998) Familial growth hormone deficiency associated with MRI abnormalities. Am J Med Genetics 80:128–132CrossRefGoogle Scholar
  5. 5.
    Argyropoulou M, Perignon F, Brauner R et al (1992) Magnetic resonance imaging in the diagnosis of growth hormone deficiency. J Pediatr 20:886–891Google Scholar
  6. 6.
    Delman BN (2009) Imaging of pediatric pituitary abnormalities. Endocrinol Metab Clin N Am 38:673–698CrossRefGoogle Scholar
  7. 7.
    Delman BN, Fatterpekar GM, Law M et al (2008) Neuroimaging for the pediatric endocrinologist. Pediatr Endocrinol Rev 5:708–719PubMedGoogle Scholar
  8. 8.
    Ouyang T, Rothfus WE, Ng JM et al (2011) Imaging of the pituitary. Radiol Clin N Am 49:549–571PubMedCrossRefGoogle Scholar
  9. 9.
    Hayakawa K, Konishi Y, Matsuda T et al (1989) Development and aging of brain midline structures: assessment with MR imaging. Radiology 172:171–177PubMedGoogle Scholar
  10. 10.
    Elster AD, Chen MY, Williams DW III et al (1990) Pituitary gland: MR imaging of physiologic hypertrophy in adolescence. Radiology 174:681–685PubMedGoogle Scholar
  11. 11.
    Argyropoulou M, Perignon F, Brunelle F et al (1991) Height of normal pituitary gland as a function of age evaluated by magnetic resonance imaging in children. Pediatr Radiol 21:247–249PubMedCrossRefGoogle Scholar
  12. 12.
    Fink AM, Vidmar S, Kumbla S et al (2005) Age-related pituitary volumes in prepubertal children with normal endocrine function: volumetric magnetic resonance data. J Clin Endocrinol Metab 90:3274–3278PubMedCrossRefGoogle Scholar
  13. 13.
    Rupp D, Molitch M (2008) Pituitary stalk lesions. Curr Opin Endocrinol Diabetes Obes 15:339–345PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Division of Endocrinology, Children’s Hospital of Eastern OntarioUniversity of OttawaOttawaCanada
  2. 2.Pediatric RadiologyChildren’s University HospitalDublin 1Ireland

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