MAGNETIC RESONANCE IMAGING (MRI) VERSUS CT SCAN IN EMPTY SELLA SYNDROME IN CHILDREN

Abstract

Primary empty sella syndrome (PESS) in children is reported in many endocrine disorders, mainly in GH deficiency. In order to better define the anatomical basis of this syndrome, 7 patients (3 girls, 4 boys) presenting with PESS and a complete and isolated GH deficiency < GH peak AITT < o ng/ml; n = 6) or an isolated diabetes insipidus (DI, n = 1) were studied by MRI.Results :The patient with isolated DI and a large sella on plain film had a true empty sella filled with CSF. 3 patients with a normal or enlarged sella on plain film had a small pituitary gland, 2 of them with a probable normal posterior lobe. 2 patients with a small sella on plain film, had a normal pituitary gland with an enlarged pituitary stalk. One patient had a normal pituitary gland.In conclusion :MRI is- superior to CT to demonstrate the anatomy of the pituitary gland. The patient with the isolated DI, with variation in polyuria, shows no identifiable antehypophyseal tissue.It is our opinion that PESS in children as defined by CT scan, groups heteroqenous anatomical anomalies well depicted by MRI.