Abstract
Contrast-enhanced brain magnetic resonance imaging (MRI) is routinely performed in children with central precocious puberty (CPP). We evaluated the value of a dedicated sellar MRI protocol without contrast enhancement in girls with CPP. This study included 261 girls diagnosed with CPP. We performed sellar MRI scanning without gadolinium enhancement of the hypothalamic-pituitary area (HPA) at the pituitary level, including additional T2-weighted imaging of whole-brain scans to check for other lesions. We evaluated the prevalence of intracranial lesions via this MR protocol. In addition,the correlation between the clinical parameters and morphology of the pituitary gland on the images was assessed. Intracranial lesions were detected in 17 (6.5%) of the 261 girls. Of the 17 girls with abnormalities, 16 (94.1%) had findings in brain areas other than the HPA. The weight, height, Tanner stage of patients were significantly (p < 0.05) higher in the group with greater pituitary height. Patient weight and height, Tanner stage of breast development, and luteinizing hormone (LH) levels were significantly (p < 0.05) greater in those with a higher pituitary grade as determined on sellar MRI. A dedicated unenhanced sellar MRI protocol provides valuable information on brain lesions and pituitary morphology. We found a significantly low prevalence of brain lesions among girls with CPP. Analysis of the height or shape of the pituitary gland on sellar MRI revealed significant correlations with the weight, height, Tanner stage, and LH levels of the patients.
Highlights
Central precocious puberty (CPP) is early development of secondary sexual characteristics before the age of 8 years in girls, caused by premature activation of the hypothalamic-pituitary-gonadal axis (HPA) [1]
The patients were divided into the following three groups according to the magnetic resonance imaging (MRI) findings: group 1, normal with no central nervous system (CNS) or hypothalamic-pituitary area (HPA) abnormalities (n = 244, 93.5%); group 2, abnormalities in the brain region but not in the HPA region: pineal cysts (n = 12), choroidal fissure cysts (n = 2), sphenoid sinus retention cysts (n = 1), and neuroepithelial cysts (n = 1); and group 3, pathological abnormalities in the HPA associated with central precocious puberty (CPP) (n = 1, 0.4%)
Recent studies that have classified girls with CPP according to age at diagnosis reported that 17.1%26.9% of girls diagnosed at age < 6 years have a CNS pathology compared to 0%-1.9% of those diagnosed at age ≥ 6 years [9,14,15,16,17]
Summary
Central precocious puberty (CPP) is early development of secondary sexual characteristics before the age of 8 years in girls, caused by premature activation of the hypothalamic-pituitary-gonadal axis (HPA) [1]. We investigated the value of a dedicated sellar MRI protocol to evaluate the hypothalamic-pituitary axis (HPA), including additional T2-weighted imaging (T2WI) of the entire brain without contrast enhancement, in girls with CPP, and we discuss the clinical findings that justify its use.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
