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Imaging of pediatric pituitary endocrinopathies.

Chaudhary V, Bano S - Indian J Endocrinol Metab (2012)

Bottom Line: Neuroimaging can be normal or disclose abnormalities related to pituitary-hypothalamic axis like (i) congenital and developmental malformations; (ii) tumors; (iii) cystic lesions; and (iv) infectious and inflammatory conditions.Classical midline anomalies like septo-optic dysplasias or corpus callosum agenesis are commonly associated with pituitary endocrinopathies and also need careful evaluation.In this radiological review, we will discuss neuroendocrine disorders related to hypothalamic pituitary-axis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis, Employees' State Insurance Corporation (ESIC) Model Hospital, Gurgaon, Haryana, India.

ABSTRACT
Accurate investigation of the hypothalamic-pituitary area is required in pediatric patients for diagnosis of endocrine-related disorders. These disorders include hypopituitarism, growth failure, diencephalic syndrome, delayed puberty, precocious puberty, diabetes insipidus, syndrome of inappropriate antidiuretic hormone (SIADH) secretion, and hyperpituitarism. Magnetic resonance imaging (MRI) is the modality of choice to visualize hypothalamic-pituitary axis and associated endocrinopathies. Neuroimaging can be normal or disclose abnormalities related to pituitary-hypothalamic axis like (i) congenital and developmental malformations; (ii) tumors; (iii) cystic lesions; and (iv) infectious and inflammatory conditions. Classical midline anomalies like septo-optic dysplasias or corpus callosum agenesis are commonly associated with pituitary endocrinopathies and also need careful evaluation. In this radiological review, we will discuss neuroendocrine disorders related to hypothalamic pituitary-axis.

No MeSH data available.


Related in: MedlinePlus

Invasive craniopharyngioma: A large complex solid and cystic sellar-suprasellar mass lesion compressing optic chiasma and hypothalamus, and extending upward into the third ventricle. The mass is extending into bilateral cavernous sinuses causing encasement of carotids and invading the floor of sella and sphenoid sinus. The cystic component (asterisk) is hyperintense on both T1 (a) and T2-weighted (b) images due to presence of cholesterol or proteinaceous material. On contrast administration (c, d) the cystic component (arrow) shows peripheral enhancement, while the solid component of the mass shows homogenous contrast enhancement. Postoperative biopsy proved invasive craniopharyngioma. [Reproduced with permission from Indian Journal of Endocrinology and Metabolism]
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Figure 2: Invasive craniopharyngioma: A large complex solid and cystic sellar-suprasellar mass lesion compressing optic chiasma and hypothalamus, and extending upward into the third ventricle. The mass is extending into bilateral cavernous sinuses causing encasement of carotids and invading the floor of sella and sphenoid sinus. The cystic component (asterisk) is hyperintense on both T1 (a) and T2-weighted (b) images due to presence of cholesterol or proteinaceous material. On contrast administration (c, d) the cystic component (arrow) shows peripheral enhancement, while the solid component of the mass shows homogenous contrast enhancement. Postoperative biopsy proved invasive craniopharyngioma. [Reproduced with permission from Indian Journal of Endocrinology and Metabolism]

Mentions: Craniopharyngiomas are commonest tumors to involve the hypothalamic/pituitary region in children aged between 5 and 10 years. In children, it is adamantinomatous histological subtype that is the most common. On MRI [Figure 2], these tumors are characterized by a complex sellar/suprasellar mass containing both cystic and solid components as well as calcification. The calcification is best appreciated on computed tomography (CT) scan. The solid component shows enhancement after contrast injection, while cystic component may show variable signal characteristics from low to high signal on T1-weighted sequences. T1-weighted hyperintense signal within the cyst is due to high content of cholesterol, protein, or desquamated cells. Large lesions may be associated with hydrocephalus. The most common neuroendocrine presentation in craniopharyngioma is growth hormone deficiency. Panhypopituitarism or diabetes insipidus is rare. Clinically, patient presents with headache, visual field defects, dioplopia, and short stature.[2627]


Imaging of pediatric pituitary endocrinopathies.

Chaudhary V, Bano S - Indian J Endocrinol Metab (2012)

Invasive craniopharyngioma: A large complex solid and cystic sellar-suprasellar mass lesion compressing optic chiasma and hypothalamus, and extending upward into the third ventricle. The mass is extending into bilateral cavernous sinuses causing encasement of carotids and invading the floor of sella and sphenoid sinus. The cystic component (asterisk) is hyperintense on both T1 (a) and T2-weighted (b) images due to presence of cholesterol or proteinaceous material. On contrast administration (c, d) the cystic component (arrow) shows peripheral enhancement, while the solid component of the mass shows homogenous contrast enhancement. Postoperative biopsy proved invasive craniopharyngioma. [Reproduced with permission from Indian Journal of Endocrinology and Metabolism]
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475890&req=5

Figure 2: Invasive craniopharyngioma: A large complex solid and cystic sellar-suprasellar mass lesion compressing optic chiasma and hypothalamus, and extending upward into the third ventricle. The mass is extending into bilateral cavernous sinuses causing encasement of carotids and invading the floor of sella and sphenoid sinus. The cystic component (asterisk) is hyperintense on both T1 (a) and T2-weighted (b) images due to presence of cholesterol or proteinaceous material. On contrast administration (c, d) the cystic component (arrow) shows peripheral enhancement, while the solid component of the mass shows homogenous contrast enhancement. Postoperative biopsy proved invasive craniopharyngioma. [Reproduced with permission from Indian Journal of Endocrinology and Metabolism]
Mentions: Craniopharyngiomas are commonest tumors to involve the hypothalamic/pituitary region in children aged between 5 and 10 years. In children, it is adamantinomatous histological subtype that is the most common. On MRI [Figure 2], these tumors are characterized by a complex sellar/suprasellar mass containing both cystic and solid components as well as calcification. The calcification is best appreciated on computed tomography (CT) scan. The solid component shows enhancement after contrast injection, while cystic component may show variable signal characteristics from low to high signal on T1-weighted sequences. T1-weighted hyperintense signal within the cyst is due to high content of cholesterol, protein, or desquamated cells. Large lesions may be associated with hydrocephalus. The most common neuroendocrine presentation in craniopharyngioma is growth hormone deficiency. Panhypopituitarism or diabetes insipidus is rare. Clinically, patient presents with headache, visual field defects, dioplopia, and short stature.[2627]

Bottom Line: Neuroimaging can be normal or disclose abnormalities related to pituitary-hypothalamic axis like (i) congenital and developmental malformations; (ii) tumors; (iii) cystic lesions; and (iv) infectious and inflammatory conditions.Classical midline anomalies like septo-optic dysplasias or corpus callosum agenesis are commonly associated with pituitary endocrinopathies and also need careful evaluation.In this radiological review, we will discuss neuroendocrine disorders related to hypothalamic pituitary-axis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis, Employees' State Insurance Corporation (ESIC) Model Hospital, Gurgaon, Haryana, India.

ABSTRACT
Accurate investigation of the hypothalamic-pituitary area is required in pediatric patients for diagnosis of endocrine-related disorders. These disorders include hypopituitarism, growth failure, diencephalic syndrome, delayed puberty, precocious puberty, diabetes insipidus, syndrome of inappropriate antidiuretic hormone (SIADH) secretion, and hyperpituitarism. Magnetic resonance imaging (MRI) is the modality of choice to visualize hypothalamic-pituitary axis and associated endocrinopathies. Neuroimaging can be normal or disclose abnormalities related to pituitary-hypothalamic axis like (i) congenital and developmental malformations; (ii) tumors; (iii) cystic lesions; and (iv) infectious and inflammatory conditions. Classical midline anomalies like septo-optic dysplasias or corpus callosum agenesis are commonly associated with pituitary endocrinopathies and also need careful evaluation. In this radiological review, we will discuss neuroendocrine disorders related to hypothalamic pituitary-axis.

No MeSH data available.


Related in: MedlinePlus