6533b834fe1ef96bd129e23e

RESEARCH PRODUCT

Sequential contrast-enhanced magnetic resonance imaging in the diagnosis of growth hormone deficiencies

L. ManfrèMario GiuffrèC. MaggioMaurizio CartaAndrea Liotta

subject

Malemedicine.medical_specialtyPathologyPituitary glandSomatotropic cellGH deficienciesEndocrinology Diabetes and MetabolismPortal venous systemPathogenesisEndocrinologyInternal medicinemedicineHumansChildGrowth hormoneGrowth DisordersPituitary stalkmedicine.diagnostic_testHuman Growth Hormonebusiness.industryMagnetic resonance imagingMagnetic Resonance ImagingGrowth hormone secretionEndocrinologymedicine.anatomical_structureContrast-enhancementPituitary GlandSequential MRIFemalebusinessMRIHormone

description

The purpose of the present study was to assess the presence and the time-course of contrast-enhancement in the pituitary gland and pituitary stalk of 24 patients with isolated growth hormone (GH) deficiency and multiple pituitary hormone deficiency. The patients were evaluated clinically (auxological measurements), endocrinologically (spontaneous GH secretion and GH stimulation tests) and with conventional MRI scans. In addition, fast-framing dynamic magnetic resonance imaging (MRI) with Gd-DTPA enhancement was used to quantitate the time course of contrast enhancement within the neurohypophysis, pituitary stalk, postero-superior adenohypophysis and antero-inferior adenohypophysis. In 3 patients without evidence of abnormalities at normal conventional MRI scans (normal anterior lobe and pituitary stalk, normal posterior lobe) and a high response to the GRF provocation test, sequential time-resolved Gd-enhanced MRI demonstrates reduced contrast enhancement in the pituitary stalk. These findings are consistent with impairment in stalk vasculature, presumably located at the level of the portal venous system, and could play a role in the pathogenesis of pituitary hormonal deficiency.

https://doi.org/10.1007/bf03343638