Abnormalities of Hypothalamic-Pituitary MR Imaging and Pituitary Function in Patients with Growth Hormone Deficiency

ABSTRACT

PURPOSE: In this study, efforts have been made to evaluate the sella MRI in 14 patients with growth hormone deficiency to define more clearly the structural abnormalities of the hypothalamo- hypophyseal axis, examine frequency of these abnormalities, and determine whether a relationship exists between the sella MRI findings and types of endocrine dysfunction. METHODS: Sella MRI was performed in 14 patients who were diagnosed as growth hormone deficiency (GHD) based on a strict diagnostic criteria. If abnormal sella MR findings were associated, then combined anterior pituitary function test was carried out. RESULTS: Among the 14 patients with GHD, complete deficiency was found in 10 patients and partial deficiency in 4 patients. Three with complete GHD showed normal MRI findings and isolated GHD only. Others revealed 3 pituitary stalk interruption syndrome (PSIS), 2 hypoplastic pituitary gland, 1 prolactinoma, and 1 Langerhans histiocytosis. These patients have multiple endocrine dysfunctions in addition to GHD. Three out of 4 patients with partial GHD, showed normal sella MR findings and isolated GHD. Only one patient with partial GHD had a delayed puberty and hypoplasia of pituitary gland. CONCLUSION: Sella MRI enables us to identify mophologic pictures in GHD previously considered 'idiopathic'. Abnormal sella MR findings strongly suggest that multiple hormone deficiencies are associated. This study justifies that routine sella MRI should be recommended in an attempt to identify the etiology of GHD in case that the diagnosis of GHD is strictly made.