Lyra Arthur, de Faria Guimarães Daniel, Meira Altino Sá, Peixoto Guilherme Vieira, Sousa E Silva Tatiane, Longui Carlos Alberto, Kochi Cristiane, da Rocha Antônio José
Unidade de Endocrinologia Pediátrica, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.
Departamento de Radiologia, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.
Arch Endocrinol Metab. 2022 Nov 17;66(6):831-836. doi: 10.20945/2359-3997000000505. Epub 2022 Aug 4.
Test if the MRI FAST1.2 protocol can detect extra-pituitary midline structural brain abnormalities in patients with ectopic posterior pituitary (EPP), and highlighting their radiological-laboratory correlations.
Cross-sectional study of patients with EPP and control group. All individuals were submitted to FAST1.2, which combines the FAST1 protocol developed by our group with 3D T2DRIVE imaging.
We evaluated 36 individuals with EPP and 78 as control group. Pituitary stalk (PS) was identified in 7/36 patients in EPP group by FAST1, and in 24/36 patients in FAST1.2 (p < 0.001). FAST1 failed to detect PS in one individual in the control group, while the FAST1.2 defined the PS in all individuals. In EPP group, eleven had interhypothalamic adhesion (IHA), three septo-optic dysplasia, and one cerebellar malformation. We didn't observe higher frequency of panhypopituitarism or developmental delay in patients with IHA. In control group, three had pars intermedia cysts, one hydrocephalus, and one hypothalamic hamartoma.
FAST1.2 allows confident recognition of midline structural abnormalities, including the pituitary stalk and IHA, thereby making MRI acquisition faster and with no need for contrast administration. IHA could be associated with defects in neuronal migration, as occur in patients with EPP, with no clinical significance.
测试MRI FAST1.2协议能否检测出异位垂体后叶（EPP）患者脑中线结构的垂体外异常，并突出其影像学与实验室检查结果的相关性。
对EPP患者和对照组进行横断面研究。所有个体均接受FAST1.2检查，该检查将我们团队开发的FAST1协议与3D T2DRIVE成像相结合。
我们评估了36例EPP患者和78例作为对照组。在EPP组中，FAST1检查在7/36例患者中识别出垂体柄（PS），而FAST1.2检查在24/36例患者中识别出PS（p<0.001）。对照组中有1例个体FAST1检查未能检测出PS，而FAST1.2检查在所有个体中均明确了PS。在EPP组中，11例有下丘脑间粘连（IHA），3例有视隔发育不良，1例有小脑畸形。我们未观察到IHA患者全垂体功能减退或发育迟缓的发生率更高。在对照组中，3例有中间部囊肿，1例有脑积水，1例有下丘脑错构瘤。
FAST1.2能够可靠地识别包括垂体柄和IHA在内的中线结构异常，从而使MRI采集更快且无需使用造影剂。IHA可能与神经元迁移缺陷有关，如EPP患者中出现的情况，无临床意义。
