Xu Chao, Zhang Xinxian, Dong Lina, Zhu Bin, Xin Tao
Department of Radiology, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China.
Exp Ther Med. 2017 Jun;13(6):3474-3478. doi: 10.3892/etm.2017.4377. Epub 2017 Apr 24.
We verified the advantages of using magnetic resonance imaging (MRI) for improving the diagnostic quality of growth hormone deficiency (GHD) in children with short stature caused by pituitary lesions. Clinical data obtained from 577 GHD patients with short stature caused by pituitary lesions were retrospectively analyzed. There were 354 cases (61.3%) with anterior pituitary dysplasia; 45 cases (7.8%) of pituitary stalk interruption syndrome (PSIS); 15 cases (2.6%) of pituitary hyperplasia due to primary hypothyroidism; 38 cases (6.6%) of Rathke cleft cyst; 68 cases (11.8%) of empty sella syndrome; 16 cases (2.8%) of pituitary invasion from Langerhans cell histiocytosis; 2 cases (0.3%) of sellar regional arachnoid cyst and 39 cases (6.8%) of craniopharyngioma. MRI results showed that the height of anterior pituitary in patients was less than normal. Location, size and signals of posterior pituitary and pituitary stalk were normal in anterior pituitary dysplasia. In all cases pituitary hyperplasia was caused by hypothyroidism. MRI results showed that anterior pituitary was enlarged, and we detected upward apophysis and obvious homogeneous enhancement. There were no pituitary stalk interruption and abnormal signal. We also observed that after hormone replacement therapy the size of pituitary gland was reduced. Anterior pituitary atrophy was observed in Rathke cleft cyst, empty sella syndrome, sellar regional arachnoid cyst and craniopharyngioma. The microstructure of hypophysis and sellar region was studied with MRI. We detected pituitary lesions, and the characteristics of various pituitary diseases of GHD in children with short stature. It was concluded that in children with GHD caused by pituitary lesions, MRI was an excellent method for early diagnosis. This method offers clinical practicability and we believe it can be used for differential diagnosis and to monitor the therapeutic effects.
我们验证了使用磁共振成像(MRI)改善因垂体病变导致身材矮小儿童生长激素缺乏症(GHD)诊断质量的优势。对577例因垂体病变导致身材矮小的GHD患者的临床资料进行回顾性分析。其中垂体前叶发育不良354例(61.3%);垂体柄中断综合征(PSIS)45例(7.8%);原发性甲状腺功能减退所致垂体增生15例(2.6%);拉克氏囊肿38例(6.6%);空蝶鞍综合征68例(11.8%);朗格汉斯细胞组织细胞增多症侵犯垂体16例(2.8%);鞍区蛛网膜囊肿2例(0.3%);颅咽管瘤39例(6.8%)。MRI结果显示患者垂体前叶高度低于正常。垂体前叶发育不良患者垂体后叶及垂体柄位置、大小及信号正常。所有垂体增生病例均由甲状腺功能减退引起。MRI结果显示垂体前叶增大,可见向上的隆起及明显均匀强化,无垂体柄中断及异常信号。我们还观察到激素替代治疗后垂体大小缩小。拉克氏囊肿、空蝶鞍综合征、鞍区蛛网膜囊肿及颅咽管瘤可见垂体前叶萎缩。用MRI研究垂体及鞍区的微观结构。我们检测到垂体病变以及身材矮小儿童GHD各种垂体疾病的特征。得出结论:在因垂体病变导致GHD的儿童中,MRI是早期诊断的极佳方法。该方法具有临床实用性,我们认为可用于鉴别诊断及监测治疗效果。