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Pediatric Radiology

, Volume 27, Issue 1, pp 48–53 | Cite as

Hypothalamic-pituitary vascularization in pituitary stalk transection syndrome: is the pituitary stalk really transected?

The role of gadolinium-DTPA with spin-echo T1 imaging and turbo-FLASH technique
  • E. Genovese
  • Mohamad Maghnie
  • Giampiero Beluffi
  • Andrea Villa
  • Luigi Sammarchi
  • Francesca Severi
  • Rodolfo Campani

Abstract

We examined 14 patients, aged 10–25 years, with idiopathic hypopituitarism. All presented an ectopic posterior pituitary at the median eminence with a hypoplastic anterior pituitary on magnetic resonance imaging (MRI). Eight patients had isolated growth hormone deficit (IGHD) and six had multiple hormone deficits (MPHD). Unenhanced MRI showed the pituitary stalk, which was extremely thin, in only three patients, while T1-weighted images obtained after intravenous injection of gadopentetate dimeglumine (Gd-DTPA) showed a thin pituitary stalk in seven patients (six with IGHD and one with MPHD), demonstrating a preserved vascular component of the stalk. MRI with Gd-DTPA was more sensitive than unenhanced MRI in detecting the pituitary stalk in patients with hypopituitarism with an ectopic posterior pituitary: the stalk was demonstrated in 50 % of the cases (seven patients), versus 21.4 % (three patients) by unenhanced MRI. The dynamic study of the hypothalamo-hypophyseal axis performed with turbo-FLASH sequences after bolus injection of Gd-DTPA showed the residual anterior pituitary to have arterial enhancement times, which suggests that an arterial system compensates for the absent or diminished blood supply from the portal system, independent of stalk detection.

Keywords

Magnetic Resonance Imaging Bolus Injection Anterior Pituitary Arterial System Portal System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • E. Genovese
    • 1
  • Mohamad Maghnie
    • 2
  • Giampiero Beluffi
    • 3
  • Andrea Villa
    • 1
  • Luigi Sammarchi
    • 1
  • Francesca Severi
    • 2
  • Rodolfo Campani
    • 1
  1. 1.Department of Radiology, IRCCS Policlinico S. Matteo, P. le C. Golgi, 1, I-27100 Pavia, ItalyIT
  2. 2.Department of Pediatrics, University of Pavia, IRCCS Policlinico S. Matteo, Pavia, ItalyIT
  3. 3.Department of Radiodiagnosis, Section of Pediatric Radiology, IRCCS Policlinico S. Matteo, Pavia, ItalyIT

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