MRI-Based Evaluation of Pituitary Size and Volume in Children with Idiopathic Growth Hormone Deficiency

Growth hormone deficiency (GHD) is the most common cause of pathological short stature of endocrine origin. Among the causes of pathological short stature, pathologies in the hypothalamic-pituitary region, especially the pituitary gland, have an important place, and imaging the region with pituitary magnetic resonance imaging (MRI) is a frequently used method in the diagnosis process and guides the diagnosis and treatment process. It is known that hypoplasia or aplasia of the pituitary gland, which plays a role in the synthesis and release of many hormones in addition to GH, causes short stature.

This study aims to evaluate pituitary size and volume as potential diagnostic markers in children with idiopathic growth hormone deficiency (IGHD) compared with healthy controls.

The study included children who presented to our hospital's pediatric endocrinology outpatient clinic with complaints of short stature/growth retardation and was diagnosed with IGHD, for whom MRI of the pituitary had been performed. Pituitary MRI examinations were retrospectively reviewed to measure the, adenohypophysis height, anterior-posterior diameter, width, and volume, and these measurements were compared with those of an age- and gender-matched control group.

A total of 55 patients diagnosed with IGHD were included, with a mean chronological age of 9.8 ± 3.4 years, of whom 58.2% (n = 32) were male. The control group consisted of 42 healthy children with a mean chronological age of 9.3 ± 3.4 years, with 47.6% (n = 20) being male. No significant differences in age and gender were found between the groups (P = 0.523, P = 0.306, respectively). Although the adenohypophysis height, anterior-posterior diameter, width, and volume of patients with IGHD were lower than those in the control group, no statistical differences were observed between the two groups (P > 0.05). There were no differences in pituitary size and volume based on gender in either group (P > 0.05). A positive correlation was found between pituitary height, width, and volume with age, insulin-like growth factor-1 (IGF-1) standard deviations (SD), and insulin-like growth factor binding protein-3 (IGFBP-3) SD (P < 0.05), whereas no correlation was found between stimulated peak GH levels and pituitary size and volume (P > 0.05).

We found that the size and volume of the adenohypophysis in patients with IGHD are not different from those of healthy peers; however, they showed a correlation particularly with IGF-1 and IGFBP-3 standard deviations.