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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

Opticochiasmatic-hypothalamic pilocytic astrocytoma: Sagittal T1-weighted (a) and coronal FLAIR (b) MR images show a large heterogeneous sellar/suprasellar mass lesion with resultant upstream obstructive hydrocephalus. Moderate but heterogeneous enhancement of mass is seen on sagittal and coronal T1-weighted postcontrast images (c, d) Note, it is difficult to differentiate whether the tumor originates from the chiasma or the hypothalamus as typically both of these structures are involved. Postsurgical biopsy proved astrocytoma
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Figure 3: Opticochiasmatic-hypothalamic pilocytic astrocytoma: Sagittal T1-weighted (a) and coronal FLAIR (b) MR images show a large heterogeneous sellar/suprasellar mass lesion with resultant upstream obstructive hydrocephalus. Moderate but heterogeneous enhancement of mass is seen on sagittal and coronal T1-weighted postcontrast images (c, d) Note, it is difficult to differentiate whether the tumor originates from the chiasma or the hypothalamus as typically both of these structures are involved. Postsurgical biopsy proved astrocytoma

Mentions: These tumors present as suprasellar mass lesions and are most commonly seen in children. These tumors are often associated with neurofibromatosis type-I (NF-1). On MRI [Figure 3], these tumors appear as well defined suprasellar mass lesions with homogenous postcontrast enhancement. Heterogeneous enhancement may be seen when the tumor is large. Often, it is difficult to differentiate whether the tumor originates from chiasma or hypothalamus as typically both of these structures are involved. In patients with NF-1, there is often involvement of optic nerves, although any portion of optic pathway may be involved. Intratumoral calcification, hemorrhage and cyst are rare. The most common neuroendocrine disorder associated with hypothalamic or chiasmatic gliomas are hypopituitarism, precocious puberty, and diencephalic syndrome (a rare cause of failure to thrive in infancy). Hypothalamic or chiasmatic astrocytomas associated with diencephalic syndrome are often larger in size, are more aggressive and may seed throughout the cerebrospinal fluid pathway.[2829]


Imaging of pediatric pituitary endocrinopathies.

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

Opticochiasmatic-hypothalamic pilocytic astrocytoma: Sagittal T1-weighted (a) and coronal FLAIR (b) MR images show a large heterogeneous sellar/suprasellar mass lesion with resultant upstream obstructive hydrocephalus. Moderate but heterogeneous enhancement of mass is seen on sagittal and coronal T1-weighted postcontrast images (c, d) Note, it is difficult to differentiate whether the tumor originates from the chiasma or the hypothalamus as typically both of these structures are involved. Postsurgical biopsy proved astrocytoma
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Opticochiasmatic-hypothalamic pilocytic astrocytoma: Sagittal T1-weighted (a) and coronal FLAIR (b) MR images show a large heterogeneous sellar/suprasellar mass lesion with resultant upstream obstructive hydrocephalus. Moderate but heterogeneous enhancement of mass is seen on sagittal and coronal T1-weighted postcontrast images (c, d) Note, it is difficult to differentiate whether the tumor originates from the chiasma or the hypothalamus as typically both of these structures are involved. Postsurgical biopsy proved astrocytoma
Mentions: These tumors present as suprasellar mass lesions and are most commonly seen in children. These tumors are often associated with neurofibromatosis type-I (NF-1). On MRI [Figure 3], these tumors appear as well defined suprasellar mass lesions with homogenous postcontrast enhancement. Heterogeneous enhancement may be seen when the tumor is large. Often, it is difficult to differentiate whether the tumor originates from chiasma or hypothalamus as typically both of these structures are involved. In patients with NF-1, there is often involvement of optic nerves, although any portion of optic pathway may be involved. Intratumoral calcification, hemorrhage and cyst are rare. The most common neuroendocrine disorder associated with hypothalamic or chiasmatic gliomas are hypopituitarism, precocious puberty, and diencephalic syndrome (a rare cause of failure to thrive in infancy). Hypothalamic or chiasmatic astrocytomas associated with diencephalic syndrome are often larger in size, are more aggressive and may seed throughout the cerebrospinal fluid pathway.[2829]

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