Avataneo T, Cirillo S, Cesarani F, Bessè F, Vannelli S, Benso L, Bona G
Istituto di Radiologia, Università di Torino.
Radiol Med. 1994 Jul-Aug;88(1-2):68-73.
Although growth hormone (GH) deficiency is a very common cause of short stature, many cases are still diagnosed as idiopathic. Magnetic Resonance Imaging (MRI), more clearly than CT, reveals the anatomy of the hypothalamic-hypophyseal region and of the possible alterations (pituitary hypoplasia, interruption of the stalk) causing hormonal deficit. Twenty-nine patients with short stature underwent MRI examinations of the hypothalamic-pituitary region to assess the significance of the correlation between hormonal test and MR patterns. Five patients had normal variants of short stature (NVSS), 7 had multiple pituitary hormone defects (MPHD) and 17 had isolated growth hormone deficiency (IGHD). In patients with MPHD or with severe isolated growth hormone deficit MRI shows interruption of the pituitary stalk with ectopy of the neurohypophysis or a mass. In patients with less severe IGHD and in NVSS, MRI demonstrates a normal pituitary region or a slightly hypoplastic gland, the neurohypophysis being normally situated. MRI may provide an ethiological classification in short stature patients. Typical MR patterns can be demonstrated in cases of dwarfism secondary to a mass in the hypothalamic-pituitary region or to morphological changes of the pituitary stalk, while in transient GH deficit no anatomical abnormalities are observed.
尽管生长激素(GH)缺乏是身材矮小的常见原因,但许多病例仍被诊断为特发性。磁共振成像(MRI)比CT更清晰地显示下丘脑 - 垂体区域的解剖结构以及导致激素缺乏的可能改变(垂体发育不全、柄中断)。29例身材矮小患者接受了下丘脑 - 垂体区域的MRI检查,以评估激素检测与MR模式之间相关性的意义。5例患者为身材矮小正常变异(NVSS),7例有多垂体激素缺陷(MPHD),17例有孤立性生长激素缺乏(IGHD)。在MPHD患者或严重孤立性生长激素缺乏患者中,MRI显示垂体柄中断伴神经垂体异位或有肿块。在轻度IGHD患者和NVSS患者中,MRI显示垂体区域正常或腺体轻度发育不全,神经垂体位置正常。MRI可为身材矮小患者提供病因分类。在下丘脑 - 垂体区域肿块或垂体柄形态改变继发的侏儒症病例中可显示典型的MR模式,而在短暂性GH缺乏中未观察到解剖学异常。