MRI-Based Evaluation of Pituitary Size and Volume in Children with Idiopathic Growth Hormone Deficiency.

Abstract

Background: Growth hormone deficiency (GHD) is the most common cause of pathological short stature of endocrine origin. Among the causes of pathological short stature, pathologies in the hypothalamic-pituitary region, especially the pituitary gland, have an important place, and imaging the region with pituitary magnetic resonance imaging (MRI) is a frequently used method in the diagnosis process and guides the diagnosis and treatment process. It is known that hypoplasia or aplasia of the pituitary gland, which plays a role in the synthesis and release of many hormones in addition to GH, causes short stature.

Aim: This study aims to evaluate pituitary size and volume as potential diagnostic markers in children with idiopathic growth hormone deficiency (IGHD) compared with healthy controls.

Methods: The study included children who presented to our hospital's pediatric endocrinology outpatient clinic with complaints of short stature/growth retardation and was diagnosed with IGHD, for whom MRI of the pituitary had been performed. Pituitary MRI examinations were retrospectively reviewed to measure the, adenohypophysis height, anterior-posterior diameter, width, and volume, and these measurements were compared with those of an age- and gender-matched control group.

Results: A total of 55 patients diagnosed with IGHD were included, with a mean chronological age of 9.8 ± 3.4 years, of whom 58.2% (n = 32) were male. The control group consisted of 42 healthy children with a mean chronological age of 9.3 ± 3.4 years, with 47.6% (n = 20) being male. No significant differences in age and gender were found between the groups (P = 0.523, P = 0.306, respectively). Although the adenohypophysis height, anterior-posterior diameter, width, and volume of patients with IGHD were lower than those in the control group, no statistical differences were observed between the two groups (P > 0.05). There were no differences in pituitary size and volume based on gender in either group (P > 0.05). A positive correlation was found between pituitary height, width, and volume with age, insulin-like growth factor-1 (IGF-1) standard deviations (SD), and insulin-like growth factor binding protein-3 (IGFBP-3) SD (P < 0.05), whereas no correlation was found between stimulated peak GH levels and pituitary size and volume (P > 0.05).

Conclusion: We found that the size and volume of the adenohypophysis in patients with IGHD are not different from those of healthy peers; however, they showed a correlation particularly with IGF-1 and IGFBP-3 standard deviations.