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Titre du Document
Dynamic MRI in the congenital agenesis of the neural pituitary stalk syndrome : the role of the vascular pituitary stalk in prediction residual anterior pituitary function
Auteur(s)
MAGHNIE M. ; GENOVESE E. ; VILLA A. ; ...
Résumé
OBJECTIVE Magnetic resonance imaging (MRI) without contrast medium is unable to give detailed information on the hypothalamic-pituitary structures. MRI using gadopentetate dimeglumine (Gd-DTPA), and dynamic MRI, were performed in patients with hypopituitarism previously diagnosed as having anterior pituitary hypoplasia, ectopic posterior pituitary and unidentified pituitary stalk (1) to determine whether Gd-DTPA improves the delineation of hypothalamic-pituitary structures; (2) to verify whether, if so, such improvement can be correlated with residual pituitary function in patients subjected to long-term follow-up ; and (3) to identify the hypothalamic-pituitary vascular network in such cases. PATIENTS Eighteen patients (13 males, 5 females) aged 10-26.4 years with unidentified pituitary stalk at first MRI study were evaluated. Eight had isolated GH deficiency (IGHD), and 10 had multiple pituitary hormone defect (MPHD) with the progression to complete anterior pituitary deficits seen by the age of 15 years in 8 patients (1 had GH and FSH-LH deficiency and 1 had GH, TSH and FSH-LH deficiency). RESULTS The MRI revealed a very thin pituitary stalk in 7 patients (38.8%), 6 with IGHD (75%) and 1 (10%) with MPHD (GH and FSH-LH deficiency), after Gd-DTPA administration. Reassessment of anterior pituitary function showed that the thyroid, adrenal and gonadal functions were intact in the 6 patients with IGHD and pituitary stalk identified by Gd-DTPA as well as in one IGHD patient with
Editeur
Blackwell
Identifiant
PMID : 8949565 ISSN : 0300-0664 CODEN : CLECAP
Source
Clinical endocrinology (Oxford. Print)) A. 1996, vol. 45, n° 3, pp. 281-290 [bibl. : 26 ref.]
Langue
Anglais
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