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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

Rathke's cleft cyst: Sagittal T1W (a), coronal T2W (b) and coronal T1W postcontrast (c) images show a subcentimeter size, non-enhancing Rathke's cleft cyst on right side, lying on surface of the gland close to the insertion of the stalk (arrow). Note, the Rathke's cleft cyst is isointense to cerebrospinal fluid.
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Figure 8: Rathke's cleft cyst: Sagittal T1W (a), coronal T2W (b) and coronal T1W postcontrast (c) images show a subcentimeter size, non-enhancing Rathke's cleft cyst on right side, lying on surface of the gland close to the insertion of the stalk (arrow). Note, the Rathke's cleft cyst is isointense to cerebrospinal fluid.

Mentions: Germinomas typically present as a suprasellar or pineal region mass in children. Synchronous occurrence of both the suprasellar and pineal region germinoma is not uncommon. Suprasellar germinomas have DI as one of the presenting complaint, reflecting involvement of hypothalamus and pituitary stalk. Characteristic MR imaging appearance of suprasellar germinoma [Figure 8] includes solid, homogenous enhancing mass involving hypothalamic region or isolated pituitary stalk thickening. There is usually no associated cyst or calcification. On CT, these lesions are slightly hyperdense. CSF seeding causing enhancement around ventricular margin is not uncommon. Tumor markers such as human chorionic gonadotropin (HCG) or alpha fetoprotein in serum/CSF, if present, can assist in making the diagnosis and obviate the need for biopsy; however, absence of these markers does not exclude the diagnosis.[45] If biopsy cannot be taken due to location, positron emission tomography (PET) scan, which is positive in germ cell tumors, can be used to assist in making the diagnosis. Germinomas are highly radiosensitive, serial follow up MRI every 3–6 months is recommended for assessment of treatment response.[46]


Imaging of pediatric pituitary endocrinopathies.

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

Rathke's cleft cyst: Sagittal T1W (a), coronal T2W (b) and coronal T1W postcontrast (c) images show a subcentimeter size, non-enhancing Rathke's cleft cyst on right side, lying on surface of the gland close to the insertion of the stalk (arrow). Note, the Rathke's cleft cyst is isointense to cerebrospinal fluid.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 8: Rathke's cleft cyst: Sagittal T1W (a), coronal T2W (b) and coronal T1W postcontrast (c) images show a subcentimeter size, non-enhancing Rathke's cleft cyst on right side, lying on surface of the gland close to the insertion of the stalk (arrow). Note, the Rathke's cleft cyst is isointense to cerebrospinal fluid.
Mentions: Germinomas typically present as a suprasellar or pineal region mass in children. Synchronous occurrence of both the suprasellar and pineal region germinoma is not uncommon. Suprasellar germinomas have DI as one of the presenting complaint, reflecting involvement of hypothalamus and pituitary stalk. Characteristic MR imaging appearance of suprasellar germinoma [Figure 8] includes solid, homogenous enhancing mass involving hypothalamic region or isolated pituitary stalk thickening. There is usually no associated cyst or calcification. On CT, these lesions are slightly hyperdense. CSF seeding causing enhancement around ventricular margin is not uncommon. Tumor markers such as human chorionic gonadotropin (HCG) or alpha fetoprotein in serum/CSF, if present, can assist in making the diagnosis and obviate the need for biopsy; however, absence of these markers does not exclude the diagnosis.[45] If biopsy cannot be taken due to location, positron emission tomography (PET) scan, which is positive in germ cell tumors, can be used to assist in making the diagnosis. Germinomas are highly radiosensitive, serial follow up MRI every 3–6 months is recommended for assessment of treatment response.[46]

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