Endocrine Abstracts

Purpose of study: The study was focused on MRI of morphological changes of pituitary gland, pituitary fossa and surrounding structures in patients with primary growth failure. We evaluated MRI, clinical status and hormonal changes in 18 patients with primary growth failure referred to University Hospital.

Methods and patients: We examined 18 patients (10 male, 8 female), average age 18.3 (2–34) years. All patients had a severe growth hormone deficiency.

MRI was performed by axial T2 weighted images of whole brain and by coronal and sagittal gradient echo T1 weighted images (T1GE) 1 mm slices of pituitary region without intravenous injection of contrast agent and in indicated patients also after intravenous injection of contrast agent. We evaluated size of pituitary fossa, pituitary gland, localization of pituitary gland, homogeneity, enhancement, and changes of parasellar structures.

Results: In all patients with primary dwarfism the adenohypophysis hypoplasia was found (18/18). The other most common findings were: very small sella – phthisis of sella or microsella in 89% (16/18), supradiaphragmatic ectopic neurohypophysis in 89% (16/18) and interrupted or hypoplastic pituitary stalk in 83% (15/18). The most frequent pathology of the surrounding structure was hypoplasia of sphenoid sinus, which was found in 67% (12/18) of our patients. Others not so frequent findings were partially empty sella, pituitary stalk elongation, pituitary gland trapped into small sella, dysgenesis of corpus callosum, remnant basipharyngeal canal, multiple neurohypophysis – ‘bright spots’ and hyperplasia of sphenoid sinus.

Summary: Primary pituitary dwarfism shows rather typical imaging of pituitary fossa and the pituitary gland: Small hypoplastic adenohypophysis, ectopic neurohypophysis, stalk hypoplasia, or interruption, multiple neurohypophysis, hypoplasia of pituitary fossa and sphenoid sinuses. The most common cause of secondary dwarfism in our patients was craniopharyngioma.