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Hypothalamic-pituitary dwarfism: Comparison between MR imaging and CT findings

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Abstract

Magnetic Resonance (MR) imaging was carried out on 33 patients with idiopathic growth hormone deficiency, in 22 of whom CT scan had been carried-out previously. Twenty-one patients presented some complications at birth. Both MR and CT were positive in the evaluation of the sella. MR imaging exhibited a higher degree of accuracy than CT in the evaluation of pituitary gland, pituitary stalk and brain anomalies.

On the basis of pituitary morphology demonstrated by MR imaging, and perinatal histories, a classification is proposed which divides our patients into three group: A) a first group of 13 patients presenting severe hypoplasia of the anterior pituitary lobe, hypoplasia of the stalk and ectopia of posterior lobe. The underlying cause of these anatomic defects might be developmental in origin, and date from early intrauterine life, probably worsened at birth. B) a second group of 10 patients presenting severe hypoplasia of the anterior pituitary lobe. A perinatal event and birth trauma might be responsible for pituitary damage. C) a third group of 10 patients with no morphological abnormalities of the pituitary gland. A derangement of the neuroendocrine mechanism which control the growth hormone secretion might account for these patients.

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References

  1. Rona RJ, Tanner JM (1977) Aetiology of idiopathic growth hormone deficiency in England and Wales. Arch Dis Child 52: 197

    PubMed  Google Scholar 

  2. Stanhope R, Hindmarsh P, Kendall B, Brook CGD (1986) High resolution CT scanning of the pituitary gland in growth disorders. Acta Paediatr Scand 75: 779

    PubMed  Google Scholar 

  3. Inoue Y, Nemoto Y, Fujita K, Aoki H, Takemoto K, Tsukamoto Y, Oda J, Onoyama Y (1986) Pituitary dwarfism: CT evaluation of the pituitary gland. Radiology 159: 171

    PubMed  Google Scholar 

  4. Lee BCP, Deck MDF (1985) Sellar and juxtasellar lesion detection with MR. Radiology 157: 143

    PubMed  Google Scholar 

  5. Kucharczyk W, Davis DO, Kelly WM, Sze G, Norman D, Newton TH (1986) Pituitary adenomas: high resolution MR imaging at 1.5 T. Radiology 161: 761

    PubMed  Google Scholar 

  6. Kucharczyk W (1987) The pituitary gland and sella turcica. In: Brant-Zawadzki M, Norman D (eds) Magnetic Resonance Imaging of the Central Nervous System. Raven Press, New York, p 187

    Google Scholar 

  7. Kucharczyk W, Peck WW, Kelly WM, Norman D, Newton TH (1987) Rathke cleft cysts: CT, MR imaging, and pathologic features. Radiology 165: 491

    PubMed  Google Scholar 

  8. Fujisawa I, Asato R, Nishimura K, Togashi K, Itoh K, Nakano Y, Itoh H, Hashimoto N, Takeuchi J, Torizuka K (1987) Anterior and posterior lobes of the pituitary gland: assessment by 1.5 T MR imaging. J Comput Assist Tomogr 11: 214

    PubMed  Google Scholar 

  9. Mark L, Pech P, Daniels D, Charles C, Williams A, Haughton V (1984) The pituitary fossa: a correlative anatomic and MR study. Radiology 153: 453

    PubMed  Google Scholar 

  10. Fujisawa I, Kikuchi K, Nishimura K, Togashi K, Itoh K, Noma S, Minami S, Sagoh T, Hiraoka T, Momoi T, Mikawa H, Nakano Y, Itoh H, Konishi J (1987) Transection of the pituitary stalk: development of an ectopic posterior lobe assessed with MR imaging. Radiology 165: 487

    PubMed  Google Scholar 

  11. Colombo N, Berry I, Kucharczyk J, Kucharczyk W, de Groot J, Larson T, Norman D, Newton TH (1987) Posterior pituitary gland: appearance on MRI images in normal and pathologic states. Radiology 165: 481

    PubMed  Google Scholar 

  12. Wolpert SM, Osborne M, Anderson M, Runge VM (1988) The bright pituitary gland. A normal MR appearance in infancy. AJNR 9: 1

    PubMed  Google Scholar 

  13. Kelly WM, Kucharczyk W, Kucharczyk J, Kjos B, Peck WW, Norman D, Newton TH (1988) Posterior pituitary ectopia: an MR feature of pituitary dwarfism. AJNR 9: 453

    PubMed  Google Scholar 

  14. Brunelle F, Lallemand D (1989) Imagerie hypothalamo-hypophysaire par resonance magnetique. Séminaire d'Endocrinologie Pediatrique et Diabetologie de l'Hôpital des Enfants Malades, Paris, 16–17 January, p 39

  15. Nishimura K, Fujisawa I, Togashi K, Itoh K, Nakano Y, Itoh H, Torizuka K (1986) Posterior lobe of the pituitary: identification by lack of chemical shift artifact in MR imaging. J Comput Assist Tomogr 10: 899

    PubMed  Google Scholar 

  16. Triulzi F, Scotti G, di Natale B, Pellini C, Chiumello G, Del Maschio A (1987) MR imaging of pituitary gland and stalk abnormalities in pituitary dwarfs with idiopathic growth hormone deficiency. Radiology 165 (P): 350

    Google Scholar 

  17. Triulzi F, Livian S, Righi C, Pieralli S, Pellini C, di Natale B, Chiumello G, Scotti G (1988) La RM nei nanismi ipopituitari idiopatici. In: Smaltino F, Elefante R, Cirullo S (eds) Neurologia oggi, Atti VII Congresso Nazionale Associazione Italiana di Neuroradiologia. Idelson, Napoli, p 89

    Google Scholar 

  18. Triulzi F, Livian S, di Natale B, Pellini C, Chiumello G, Pieralli S, Righi C, Scotti G (1988) Pituitary and brain anomalies in pituitary dwarfs: MR findings in 49 patients. Radiology 169 (P): 172

    Google Scholar 

  19. Calzada L-D, Chaussain J-L, Job J-C (1978) Etiologie et associations du nanisme hypophysaire. Etude d'une serie de 135 cas. Arch Franç Pèd 35: 144

    Google Scholar 

  20. Steendijk R (1980) Diagnostic and aetiologic features of idiopathic and symptomatic growth hormone deficiency in the Netherlands. A survey of 176 children. Helv Paediatr Acta 35: 129

    PubMed  Google Scholar 

  21. Peyster RG, Hoover ED, Adler LP (1984) CT of the normal pituitary stalk. AJNR 5: 45

    PubMed  Google Scholar 

  22. Seidel FG, Towbin R, Kaufman RA (1985) Normal pituitary stalk size in children: CT study. AJNR 6: 733

    Google Scholar 

  23. Roppolo HMN, Latchaw RE, Meyer JD, Curtin HD (1983) Normal pituitary gland: 1. Macroscopic anatomy-CT correlation. AJNR 4: 927

    PubMed  Google Scholar 

  24. Roppolo HMN, Latchaw RE (1983) Normal pituitary gland: 2. Microscopic anatomy-CT correlation. AJNR 4: 937

    PubMed  Google Scholar 

  25. Milner R, Burns E (1982) Investigation of suspected growth hormone deficiency. Arch Dis Child 57: 944

    PubMed  Google Scholar 

  26. Preece MA (1981) Growth hormone deficiency. In: Brook CGD (ed) Clinical paediatric endocrinology. Blackwell Oxford, p 285

    Google Scholar 

  27. Shulman DI, Martinez CR, Bercu BB, Root AW (1986) Hypothalamic-pituitary dysfunction in primary empty sella syndrome in childhood. J Pediatr 108: 540

    PubMed  Google Scholar 

  28. Stanhope R, Adlard P (1987) Empty sella syndrome. Dev Med Child Neurol 29: 394

    PubMed  Google Scholar 

  29. Haughton VM, Rosenbaum AE, Williams AL, Drayer B (1980) Recognizing the empty sella by CT: the infundibulum sign. AJNR 1: 527

    Google Scholar 

  30. Costigan DC, Daneman D, Harwood-Nash D, Holland FJ (1984) The “empty sella” in childhood. Clin Pediatr 23: 437

    Google Scholar 

  31. di Natale B, Scotti G, Pellini C, Del Maschio A, Triulzi F, Petecca C, Uboldi F, Chiumello G (1987) Empty sella in children with pituitary dwarfism: does it exist? Pediatrician 14: 246

    PubMed  Google Scholar 

  32. Beutler A, Taviere V, Barth MO, Poree C, Lallemand D (1988) MRI findings in primary hypopituitarism with “empty sella” syndrome in children. Pediatr Radiol 18: 252 (A)

    PubMed  Google Scholar 

  33. Reid JD (1960) Congenital absence of the pituitary gland. J Pediatr 56: 658

    PubMed  Google Scholar 

  34. Johnson JD, Hansen RC, Albritton WL, Werthemann U, Christiansen RO (1973) Hypoplasia of the anterior pituitary and neonatal hypoglycemia. J Pediatr 82: 634

    PubMed  Google Scholar 

  35. Fujisawa I, Nishimura K, Asato R, Togashi K, Itoh K, Noma S, Kawamura Y, Sago T, Minami S, Nakano Y, Itoh H, Torizuka K (1987) Posterior lobe of the pituitary in diabetes insipidus: MR findings. J Comput Assist Tomogr 11: 221

    PubMed  Google Scholar 

  36. Chiumello G, di Natale B, Pellini C, Beneggi A, Scotti G, Triulzi F (1989) Magnetic Resonance imaging in diabetes insipidus. Lancet I: 901

    Article  Google Scholar 

  37. Takor Takor T, Pearse AGE (1975) Neuroectodermal origin of avian hypothalamo-hypophyseal complex: the role of the ventral neural ridge. J Embryol Exp Morphol 34: 311

    PubMed  Google Scholar 

  38. Mulchahey JJ, Di Blasio AM, Martin MC, Blumenfeld Z, Jaffe RB (1987) Hormone production and peptide regulation of the human fetal pituitary gland. Endocr Rev 8: 406

    PubMed  Google Scholar 

  39. Triulzi F, Scotti G, Pieralli S, Righi C, Visciani A, Livian S (1989) MR imaging detection of pituitary and brain anomalies in pituitary dwarfs. In: Nadjmi M (ed) XVth Congress of the European Society of Neuroradiology. Springer, Berlin Heidelberg New York, p 469

    Google Scholar 

  40. van der Knaap MS, Valk J (1988) Classification of congenital abnormalities of the CNS. AJNR 9: 315

    PubMed  Google Scholar 

  41. Curatolo P, Cusmai R, Bruni O, Pruna D, Arpino C (1989) Aspetti precoci delle epilessie parziali precoci. In: Benedetti P, Curatolo P, Ottaviano S (eds) Atti Xo Convegno di Neurologia dell'eta' evolutiva, Roma 14–16 Aprile

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Authors and Affiliations

  1. Department of Pediatrics, University of Pavia, Pavia

    M. Maghnie, D. Larizza & F. Severi

  2. Department of Neuroradiology, University of Milan, IRCCS H.S. Raffaele, Milan

    F. Triulzi & G. Scotti

  3. Department of Radiodiagnosis, IRCCS Policlinico S. Matteo, Pavia, Italy

    A. Cecchini

  4. Section of Pediatric Radiology, IRCCS Policlinico S. Matteo, Pavia, Italy

    G. Beluffi

  5. Pediatric Clinic of the University Piazzale Golgi, IRCCS Policlinico S. Matteo, I-27100, Pavia PV, Italy

    M. Maghnie

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  1. M. Maghnie
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Maghnie, M., Triulzi, F., Larizza, D. et al. Hypothalamic-pituitary dwarfism: Comparison between MR imaging and CT findings. Pediatr Radiol 20, 229–235 (1990). https://doi.org/10.1007/BF02019654

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