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垂体磁共振成像结果与生长激素缺乏症的临床和实验室检查结果的相关性。

Relevance of Pituitary Gland Magnetic Resonance Imaging Results with Clinical and Laboratory Findings in Growth Hormone Deficiency.

机构信息

Department of Pediatric Endocrinology, Ankara Child Disease Hematology Oncology Training and Research Hospital, Ankara, Turkey.

Department of Radiology, Ankara Child Disease Hematology Oncology Training and Research Hospital, Ankara, Turkey.

出版信息

Med Sci Monit. 2018 Dec 30;24:9473-9478. doi: 10.12659/MSM.911977.

Abstract

BACKGROUND The present study investigated the relationship between detection of organic pathologies with magnetic resonance imaging of the pituitary gland, clinical and laboratory findings, and treatment response. MATERIAL AND METHODS The study included a total of 183 patients who had isolated growth hormone deficiency, received at least 1 year of treatment, returned regularly for follow-ups, and whose pituitary magnetic resonance images were available. The patients were divided into 2 groups: those with and without pathological evidence with magnetic resonance imaging. Clinical and laboratory features and treatment responses were compared between patients with and without pathological evidence with magnetic resonance imaging. RESULTS Of the 183 patients, 105 were females and 78 were males, and 114 patients (62.2%) were prepubertal and 69 patients (37.8%) were pubertal. Their mean age was 10.01±3.25 years (1-17.6 years). Pituitary images of 153 (83.6%) patients were normal. Of the patients with detected pathologies (16.4%), 19 (10,4%) had pituitary hypoplasia, 5 (2.7%) had partial empty sella, 3 (1.7%) had ectopic neurohypophysis and 3 (1.7%) had empty sella, pineal, and arachnoid cyst. A statistically significant increase was observed in the height increase rate after treatment compared to before treatment in both groups (p<0.001). However, the group with pathology had a statistically significant (p=0. 007) post-treatment increase height rate. Although in the group with pathology there was a lower L-DOPA and clonidine peak GH response, there was not any statistically significant difference between the 2 groups (p=0.051, p=0.113). Pituitary gland length was also shorter in the group with pathology compared to the group without pathology (P<0.001). CONCLUSIONS Magnetic resonance imaging is a useful tool in assessing GH deficiency pathogenesis and in predicting treatment response.

摘要

背景

本研究旨在探讨垂体磁共振成像(MRI)检测到的有机病变与临床和实验室检查结果以及治疗反应之间的关系。

材料与方法

本研究共纳入 183 例单纯生长激素缺乏症患者,这些患者接受了至少 1 年的治疗,定期复诊,且垂体 MRI 图像可供分析。将患者分为 MRI 显示存在和不存在病理学证据两组,比较两组患者的临床和实验室特征及治疗反应。

结果

183 例患者中,女性 105 例,男性 78 例;114 例(62.2%)为青春期前,69 例(37.8%)为青春期后。患者的平均年龄为 10.01±3.25 岁(1-17.6 岁)。153 例(83.6%)患者的垂体图像正常。在检测到病变的患者中(16.4%),19 例(10.4%)存在垂体发育不全,5 例(2.7%)存在部分空蝶鞍,3 例(1.7%)存在异位神经垂体,3 例(1.7%)存在空蝶鞍、松果体和蛛网膜囊肿。两组患者治疗后的身高增长率均显著高于治疗前(p<0.001)。然而,存在病理学证据的组在治疗后身高增长率有显著增加(p=0.007)。尽管存在病理学证据的组中 L-DOPA 和可乐定激发试验的 GH 峰值反应较低,但两组间无显著差异(p=0.051,p=0.113)。与无病理学证据的组相比,存在病理学证据的组的垂体长度更短(P<0.001)。

结论

MRI 是评估 GH 缺乏症发病机制和预测治疗反应的有用工具。

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