MRI of the Hypothalamic Hypophyseal Region in Children with Growth Hormone Deficiency

Abstract

We correlated alterations in the hypothalamic-hypophyseal region studied by MRI with growth hormone deficiency (GHD). Fifty-four patients (38 male; 16 female) with clinical and biochemical diagnosis of GHD were examined in a 1.5 T magnet (Signa GE), using coronal and sagittal T1WI 3 mm slices.

Isolated GHD (IGHD) was considered in all patients stature shorter than 2.5 SD for age, growth velocity less than 4.0 cm/year. Multiple Pituitary Hormone Deficiency (MPHD) was found in 35 patients (64.8%). IGHD was found in 19 patients (35.2%). Ectopic posterior hypophysis was found in 35 patients. From these 25 patients (71%) were MPHD and 10 patients (29%) were IGHD. The values found for stalk thickness and anterior hypophyseal height and volume were greater in patients with IGHD than in patients with MPHD. The present study permitted the standardization of the measurements of the structures of the hypothalamic-hypophyseal region, stalk and chiasm, in patients with GHD. MRI of the hypothalamic-hypophyseal region is helpful in the diagnosis of GHD. Although 60% of patients with GHD may not show typical alterations on MRI the findings of ectopic posterior hypophysis in patients with IGHD reduce the possibility of having MPHD.