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[Craniocerebral imaging in children with short stature]
L Barros1, C Ribeiro, M Bastos
1Departamento de Neuroradiologia, Hospitais da Universidade de Coimbra.
Insights
Cranial CT and NMR imaging reveal frequent anomalies in children with short stature, particularly hypoplastic pituitary, aiding in diagnosing idiopathic growth hormone deficiency (GHD). These imaging techniques are essential for comprehensive evaluation.
Area of Science:
- Pediatric Endocrinology
- Neuroradiology
- Medical Imaging
Background:
- Short stature in children can stem from various causes, including growth hormone deficiency (GHD).
- Accurate diagnosis requires comprehensive evaluation, including imaging of the pituitary and surrounding structures.
- Cranial imaging, such as CT and NMR, plays a crucial role in identifying structural abnormalities.
Purpose of the Study:
- To analyze the types and frequency of cranial CT and NMR imaging anomalies in children presenting with short stature.
- To determine the association between specific imaging findings and different etiological groups of short stature.
Main Methods:
- A cohort of 57 children with short stature and criteria for GHD underwent cranial CT or NMR imaging.
- Children were classified into groups: Isolated GHD (IGHD), Multiple Pituitary Hormone Deficiency (MPHD), Neurosecretory Dysfunction (NSD), Turner syndrome, and Idiopathic Short Stature (ISS).
- Pituitary function and karyotype were assessed prior to imaging.
Main Results:
- Cranial CT/NMR anomalies were detected in 64.9% of the studied children.
- Hypoplastic pituitary was the most frequent anomaly (50% in IGHD, 37.5% in NSD, 33.3% in MPHD).
- Other anomalies included empty sella (7 patients) and, in NMR scans, pituitary stalk abnormalities (8 patients) and ectopic neurohypophysis (2 patients).
Conclusions:
- Cranial CT and NMR imaging are essential for evaluating children with short stature.
- Imaging findings, especially hypoplastic pituitary, can aid in diagnosing idiopathic GHD.
- These investigations help identify tumors and other structural causes of short stature.
Objective:
To analyse the type and frequency of cranial CT and NMR imaging anomalies in children of short stature.
Patients And Interventions:
We studied 57 children of short stature with a mean age (+/-SD) of 10.1 +/- 3.8 years, 34 boys and 23 girls, all of them with auxometric criteria of GH deficiency. After studying the pituitary function and determination of karyotype in the girls, the children were classified in to five groups:-Isolated GHD (IGHD) (n = 32), multiple pituitary hormone deficiency (MPHD) (n = 6), neurosecretory dysfunction (NSD) (n = 8), Turner syndrome (n = 7) and idiopathic short stature (ISS) (n = 4). The imaging methods used were cranial CT or NMR.
Results:
Of the 57 children studied the CT/NMR was abnormal in 37(64.9%) children. We found anomalies in 65.6% of IGHD patients, 62.5% of NSD patients, 100% of MPHD patients and 57.1% and 25% in the Turner s. patients and ISS patients respectively. The most frequent anomaly was hypoplastic pituitary found in 50% of IGHD patients, 37.5% of NSD patients and 33.3% of MPHD patients. None of the cases of Turner s. or ISS had hypoplastic pituitary. An empty sella was the second most frequent anomaly found in 7 patients (IGHD-3, MPHD-3, DNS-1). Of the 25 children in which NMR was performed, 8 had hypoplastic pituitary and stalk and 2 had interruption of the pituitary stalk and ectopic neurohypophysis.
Conclusion:
These results strengthen the necessity for CT/NMR imaging in children of short stature which, besides allowing identification of tumors, also permits the diagnosis of idiopathic GHD because of its frequent association with cranial imaging anomalies, mainly hypoplastic pituitary.