Abstract
The aim of the present study was to obtain standard reference values for the pituitary gland volumes of healthy children and to analyze the potential diagnostic values of pituitary gland volumetry for growth hormone deficiency (GHD) and idiopathic short stature (ISS). The volume of the pituitary gland was measured using a thin-section three-dimensional (3D) magnetic resonance imaging (MRI) sequence of magnetization-prepared rapid gradient echo imaging with a section thickness of 1 mm. A group of 75 healthy children aged between 1 and 19 years were recruited to obtain normal volumetry values of the pituitary gland. These individuals demonstrated no evidence of abnormalities to the central nervous or endocrine systems prior to the study. An additional group of 55 children with GHD (n=32) or ISS (n=23) aged between 0 and 14 years were included in the measurement of pituitary gland volume and height. The Student’s t-test was used to evaluate the repetition test, while Pearson’s correlation coefficient and regression analyses were performed to examine the correlations between the volume and height of the pituitary glands. Pituitary gland volume and height demonstrated an increasing trend with age in the healthy children. In addition, the pituitary gland volume exhibited a growth spurt in the early teenage years (10–14 years-old), which was more prominent in females. The growth spurt was not observed for pituitary gland height. When compared with the healthy children, 65.6% of the children with GHD and 34.8% of the children with ISS had smaller pituitary gland volumes. Similarly, 37.5% of the children with GHD and 26.1% of the children with ISS had a smaller pituitary gland height compared with the healthy children. The pituitary gland volume performed significantly better compared with height with regard to the detection rate. Therefore, the results indicated that 3D MRI volumetry was useful for understanding the developmental characteristics of the pituitary gland in healthy children, and that the reference data provided by 3D MRI were effective in the diagnosis of short stature following associations with neuroimaging and clinical functional abnormalities of the pituitary gland.
Highlights
Growth hormone deficiency (GHD), caused by problems arising in the pituitary gland, is a medical condition in which the body does not produce sufficient growth hormone (GH)
To examine the association between pituitary gland volume and height with age, magnetic resonance imaging (MRI) was performed on 75 healthy children
Minor changes in pituitary gland height are often difficult to detect as the morphology of the pituitary gland and sella turcica can interfere with accurate measurements
Summary
Growth hormone deficiency (GHD), caused by problems arising in the pituitary gland, is a medical condition in which the body does not produce sufficient growth hormone (GH). Idiopathic short stature (ISS) may be one of the causes of short stature [1] This condition refers to short children without an identifiable disorder of the GH/insulin‐like growth factor axis or other endocrine, genetic or organ system disorders [2]. Neuroimaging has become an essential part of the diagnostic process for children with GHD in measuring gland size due to the excellent contrast and high spatial resolution [3,4]. The variation in shape of the pituitary gland between individuals means that any assessment of size is likely to be subject to a high degree of imprecision unless a true volume is measured [11]
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