Pituitary stalk interruption syndrome in 59 children: the value of MRI in assessment of pituitary functions
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Pituitary imaging abnormality is a specific indicator of hypopituitarism. This study involved a retrospective review of 59 children diagnosed with pituitary stalk interruption syndrome (PSIS). Of the 59 eligible patients, 54 were born by breech delivery, and there was a significant difference between numbers of patients with breech and head-presenting birth. In order to discuss the relationship between pituitary functions and delineation of pituitary structure in magnetic resonance imaging (MRI), a control analysis was carried out in children with PSIS. Fifty-nine children were subdivided into two groups: group I (partial PSIS, 20 cases) and group II (complete PSIS, 39 cases). There was a significantly small anterior pituitary in both groups of PSIS compared with controls (P < 0.001). The incidence of ectopic posterior pituitary (EPP) was significantly higher in group II (P < 0.001). Before and after hormone replacement therapy, pituitary functions were measured and compared with controls. The levels of growth hormone (GH), free thyroxine (FT4), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), and cortisol (COR) were significantly lower in group II (P < 0.05). The dosage of levothyroxine sodium in group II was significantly higher than in group I (P < 0.01). Conclusion. On the basis of birth history, breech presentation may a forewarning for subsequent pituitary hormone deficiencies. Grades of MRI can predict occurrence and severity of PSIS, which are also correlated with the levels of the pituitary target hormone deficiencies. Interruption of pituitary stalk and ectopic posterior pituitary both represent important markers of pituitary structure and function.
KeywordsPituitary stalk interruption syndrome 3.0 T magnetic resonance imaging Pituitary function Hormone replacement therapy
This study was supported by a grant from Shandong Science and Technology Commission (No. 2013GSF11817), China. The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation of the manuscript. The authors have disclosed no relevant financial relationship. We are grateful to all the patients involved in this study. We would like to thank editorial assistance in the preparation of this manuscript.
Conflict of interest
Dr. Li is an employee of Provincial Hospital affiliated to Shandong University and has applied for funding of the above research. Qian Wang, Yanyan Hu, and Xiaojun Sun are all graduate students of Provincial Hospital affiliated to Shandong University. Dr. Li took charge of this study. All authors declare that they have no conflict of interest.
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