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Pituitary stalk and ectopic hyperintense T1 signal on magnetic resonance imaging. Implications for anterior pituitary
M C Ultmann1, S F Siegel, W L Hirsch
1Department of Pediatrics, University of Pittsburgh, Pa.
Insights
Magnetic resonance imaging (MRI) of the pituitary gland helps correlate neuroanatomy with endocrine function. Ectopic posterior pituitary tissue and pituitary stalk appearance on MRI predict anterior pituitary hormone status in children.
Area of Science:
- Pediatric Endocrinology
- Neuroimaging
- Developmental Biology
Background:
- Ectopic posterior pituitary tissue is a rare condition affecting endocrine function.
- Magnetic resonance imaging (MRI) provides detailed visualization of the hypothalamic-pituitary axis.
Purpose of the Study:
- To correlate detailed hypothalamic-pituitary neuroanatomy visualized by MRI with anterior and posterior pituitary endocrine function.
- To investigate the relationship between the posterior pituitary hyperintense T1 signal and pituitary endocrine status.
Main Methods:
- Retrospective review of records of children with ectopic posterior pituitary tissue identified at a specialized endocrine clinic.
- Correlation of anterior pituitary hormone status (determined by standard testing) with hypothalamic-pituitary region morphology on MRI.
Main Results:
- Patients were classified into two groups based on pituitary stalk appearance on MRI: attenuated stalk (Group 1) and nonvisualized stalk (Group 2).
- Group 1 patients exhibited partial anterior pituitary function, while Group 2 patients presented with panhypopituitarism.
Conclusions:
- MRI-based delineation of hypothalamic-pituitary neuroanatomy, particularly the pituitary stalk, is crucial for assessing endocrine function in children with ectopic posterior pituitary tissue.
- Further prospective studies are warranted to elucidate the pathophysiology of idiopathic hypopituitarism.
Objective:
To determine if improved delineation of hypothalamic-pituitary neuroanatomy by magnetic resonance imaging, especially the posterior pituitary hyperintense T1 signal, can be correlated with anterior and posterior pituitary endocrine function.
Design:
Children with ectopic posterior pituitary tissue were identified at the Endocrine Clinic of the Children's Hospital of Pittsburgh (Pa) and their records were reviewed.
Participants:
Ten children with ectopic posterior pituitary tissue.
Measurements:
Anterior pituitary hormone status, determined by standard testing, was correlated with the morphologic anomalies of the hypothalamic-pituitary region on magnetic resonance imaging.
Results:
Patients were categorized by the appearance of the pituitary stalk based on the magnetic resonance image: attenuation of the stalk (group 1) or nonvisualization of the stalk (group 2). Patients in group 1 retained partial anterior pituitary function. Patients in group 2 had panhypopituitarism.
Conclusion:
Prospective evaluation of affected individuals may provide insight into the pathophysiologic mechanisms of idiopathic hypopituitarism.