Key result
Growth hormone deficiency in children was associated with a high frequency of hypothalamic-pituitary anomalies on MRI, including an absent pituitary stalk and ectopic posterior lobe in 59% of patients.
Why the study?
The relationship between hypothalamic-pituitary morphological abnormalities detected by MRI and endocrine function in children with growth hormone deficiency was unclear.
Does MRI detect morphological abnormalities in the hypothalamus and pituitary gland of children with growth hormone deficiency compared to healthy controls?
Case-Control (n=72)
Does MRI detect morphological abnormalities in the hypothalamus and pituitary gland of children with growth hormone deficiency compared to healthy controls?
MRI reveals a high frequency of hypothalamic-pituitary anomalies, particularly an absent pituitary stalk and ectopic posterior lobe, in children with growth hormone deficiency, especially those with multiple pituitary hormone deficiency.
Answers are grounded in this paper and cite their sources.
MRI anomalies common in pediatric GHD; hypothesis-generating for routine imaging, needs prospective validation before practice change.
Fifty-seven children with growth hormone deficiency and 15 healthy age-matched controls were studied by magnetic resonance imaging (MRI). Of the patients, 36 (63%) had isolated GH deficiency (IGHD) and 21 (37%) multiple pituitary hormone deficiency (MPHD). MRI studies showed a marked reduction in pituitary volume in all patients in comparison with normal controls. Moreover, a striking morphological abnormality with the apparent absence of the pituitary stalk and an ectopic posterior pituitary lobe was detected in 34 of the patients (59%). This pituitary stalk abnormality was detected in 95% of the MPHD patients and in 39% of the IGHD patients. All but one of the patients with a normal pituitary stalk had IGHD. Endocrine evaluation showed no correlation with MRI data: in particular patients with an apparent anatomical interruption of the hypothalamic-pituitary axis showed a variety of patterns of hormonal responses. In conclusion, our study shows a high frequency of hypothalamic-pituitary anomalies in patients with GH deficiency, particularly related with MPHD. However, further studies are needed to improve our understanding of the relationship between MRI and endocrine data.
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Bressani et al. (2008) conducted a case-control in Growth hormone deficiency (n=72). Growth hormone deficiency vs. Healthy age-matched controls was evaluated on Morphological abnormality (apparent absence of the pituitary stalk and an ectopic posterior pituitary lobe). Growth hormone deficiency in children was associated with a high frequency of hypothalamic-pituitary anomalies on MRI, including an absent pituitary stalk and ectopic posterior lobe in 59% of patients.
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