正常青少年垂体MRI研究

MRI study of normal pituitary glands in stage of puberty

目的研究正常青少年垂体大小、形态变化及其与年龄、身高、体重的相关性。方法选取152例6.0～18.9岁正常青少年的垂体MRI资料,于SE序列T1WI头颅正中矢状及冠状面上观测垂体大小形态及信号特征。结果得到6～<10岁、10～<15岁、15.0～18.9岁3组正常垂体大小、形态及信号特征资料。在10～<15岁、15.0～18.9岁组,男性隆凸型分别占47.6%(10/21)、52.0%(13/25),球形垂体分别占14.3%(13/21)、32.0%(8/25);女性隆凸型分别占70.9%(22/31)、90.0%(18/20),球形垂体分别占45.2%(14/31)、60.0%(12/20)。青春发育期腺垂体与年龄呈正相关生长(r男=0.74,t=3.624,P=0.004;r女=0.94,t=9.562,P=0.000),与身高、体重无明显相关性(P>0.05)。结论青春发育期垂体大小、形态变化大,随年龄增长,垂体明显增生肥大,垂体上缘也逐渐隆凸。球形垂体在青春发育期可为正常现象,在青春期女性中占有很大比率,易与垂体微腺瘤混淆,需结合临床及生化检查结果,避免误诊。

Objective To study the changes of shape, size and signal intensity of normal pituitary glands in adolescents and to correlate the size and shape of normal pituitary glands with the age, height and weight in stage of puberty. Methods One hundred and fifty-five cases of MRI data of pituitary glands in normal adolescents range from 6.0 year to 18.9 year were used. Using high-field 1.5 T MR scanner, the appearances of pituitary glands in 152 normal adolescents were analyzed on T1WI in standard median sagittal and coronal plane. Results Three groups quantitative data of size, shape and single intensity changes of normal pituitary glands were obtained, which were divided into 6 - 〈 10 years old, 10 - 〈 15 years old, 15.0 - 18.9 year group in adolescents. The convex pituitary gland of male and female subjects were 47. 6% and 71.0% in 10- 〈15.0 years old year group, 52. 0% and 90. 0% in 15.0-18.9 year group. The percent of the spheroid pituitary glands were 14. 3% and 45.2% in 10. 0 - 〈 15.0 years old group, 32. 0% and 60. 0% in 15.0 - 18.9 year group for male and female subjects respectively. The size of pituitary glands was significantly correlated with the age （ r m= 0. 74, t = 3. 624, P = 0. 004 ; rf = 0. 94, t = 9. 562, P = 0. 000）, however, it was not markedly correlated with the height and weight （P 〉 0. 05 ）. Conclusion Obvious changes of the size and shape of pituitary glands were found in health adolescents. The pituitary glands manifest physiologic hypertrophy with more convex of upper border when age increased in stage of puberty. The spherical appearance of the pituitary glands is a normal developmental feature and should not warrant clinical investigation for the presence of an underlying micro-adenoma in teenage females.