MR IMAGING AND HORMONAL FINDINGS IN PATIENTS WITH IDIOPATHIC GROWTH HORMONU DEFICIENCY

Abstract

Until the introduction of MR imaging in neuroradiological diagnostic, diagnosis of the ecotopic posterior pituitary lobe, first described by the pathologist Priesel in 1920, was rare. Recently it has increasingly been diagnosed by MR in patients whose anamnesis showed birth trauma. We performed MR of the hypothalamic-pituitary region in 17 patients with idiopathic growth hormone deficiency. 8 patients had additional deficiencies of the anterior pituitary lobe whereas the function of the posterior lobe of the hypophysis was normal in all patients. Indications of birth trauma were present in only 2 patients. The cause of anterior lobe insufficiency was determined by MR in 8 patients with panhypopituitarism to be the result of the absence of the pituitary stalk. In 5 patients with isolated HGH deficiency the stalk was extremely hypoplastic. The posterior lobe was imaged in 11 patients as an ectopic bright spot of a small nodule at the median eminence and in 2 patients in the proximal infundibulum whereas in 3 patients other cerebral malformations were evident. Only in 1 patient there was no pathological finding in the hypothalamic-pituitary region. As the anamnesis showed indications of birth trauma in only 2 patients, we conclude that the absence or hypoplasia of the stalk and ectopia of the posterior lobe may frequently be of developmental origin and date from early intrauterine life.