Zgliczyński W, Brzeziński J, Brzezińska A, Słowińska-Srzednicka J, Walecki J
Klinika Endokrynologii CMKP, Szpital Bielański, Warszawa.
Endokrynol Pol. 1992;43(3):210-21.
Hypopituitarism can be a result of various lesions of hypothalamus, pituitary stalk, or of the pituitary gland itself. The aim of the study was to assess the value of CT and MRI examinations in determination of the cause of hypopituitarism. Seventeen patients with hypopituitarism (9 women and 8 men) aged 22 to 61 years have been examined. In three cases growth deficiency was observed, 4 women had galactorrhoea, 4 patients had diabetes insipidus, 16 patients had supra-adrenal insufficiency, 14 had signs of hypogonadism and 10 hypothyroidism. In each case plasma concentrations of LH, FSH, PRL, TSH, alpha-subunit, ACTH before and after appropriate stimulation with TRH, metoclopramid, LH-RH, GRF or metyrapon were determined with RIA. Every patient was examined both with CT and MRI (0.5 T Toshiba MRT 50a). All 17 patients had abnormal MR images of hypothalamo-pituitary area, while only 10 of them had abnormalities in their CT scans. In remaining 7 patients the MRI revealed: three cases of congenital malformation of hypophyseal stalk, two cases of empty sella, one posttraumatic lesion of the stalk and one case of granulomatous infiltration of the stalk. We found MRI superior to CT in establishing the case of hypopituitarism.
垂体功能减退可能是下丘脑、垂体柄或垂体本身各种病变的结果。本研究的目的是评估CT和MRI检查在确定垂体功能减退病因方面的价值。对17例年龄在22至61岁之间的垂体功能减退患者（9名女性和8名男性）进行了检查。观察到3例生长发育迟缓，4名女性有溢乳，4例患者患有尿崩症，16例患者有肾上腺皮质功能不全，14例有性腺功能减退体征，10例有甲状腺功能减退。在每例患者中，在给予TRH、甲氧氯普胺、LH-RH、GRF或美替拉酮进行适当刺激前后，用放射免疫分析法测定血浆中LH、FSH、PRL、TSH、α亚基、ACTH的浓度。每位患者均接受了CT和MRI检查（0.5T东芝MRT 50a）。所有17例患者下丘脑-垂体区域的MR图像均异常，而CT扫描中只有10例异常。在其余7例患者中，MRI显示：3例垂体柄先天性畸形，2例空蝶鞍，1例垂体柄创伤后病变，1例垂体柄肉芽肿浸润。我们发现MRI在诊断垂体功能减退病例方面优于CT。
