Neuroimaging findings of the hypothalamus and pituitary gland in children with growth hormone deficiency: a 25-year single-center retrospective study.
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PURPOSE: Growth hormone deficiency (GHD) is a cause of short stature in childhood. Central nervous system imaging, including hypothalamic-pituitary magnetic resonance imaging (MRI) is important for the diagnostic investigation of these patients. The aim of this descriptive study was to examine the MRI findings of the hypothalamus-pituitary area in children with GHD. METHODS: Medical records and MRI findings of the hypothalamus and pituitary gland were retrospectively reviewed for all patients diagnosed with GHD and treated with recombinant human GH during the 25-year period 1999-2024. RESULTS: The study included 194 patients (138 boys, mean age at diagnosis 10.34 (4) years). Normal imaging findings were observed in 121/194 patients (62.3%), while abnormal findings were noted in 73/194 (37.6%) patients. Isolated or combined congenital structural anomalies of the hypothalamus-pituitary region, congenital pituitary variants, and tumors were also observed. The most frequent congenital imaging pituitary variants were pituitary hypoplasia, a partially empty sella turcica, and an ectopic posterior pituitary. Regarding tumors, 4/194 (2.1%) patients were diagnosed with craniopharyngiomas and 3/194 (1.5%) participants were diagnosed with germinomas in the hypophysis-hypothalamus region. Brain medulloblastomas were found in 3/194 (1.5%) patients. The 93.2% of the study sample (181/194) was diagnosed with isolated GHD, while in 13 patients (6.7%) multiple pituitary hormone insufficiency was established. CONCLUSIONS: Imaging of the hypothalamus and pituitary in children with GHD is essential and often reveals benign findings/variants in the region, which should be taken into account during long-term follow-up for possible deficiency of other hormones. Craniopharyngiomas remain the most common tumor causing GHD.