生长激素缺乏症患儿垂体MRI检查的临床应用价值

MRI of the pituitary in patients with growth hormone deficiency

目的研究特发性生长激素缺乏症(GHD)儿童垂体MRI检查的临床应用价值,为进一步探索GHD病理机制提供临床依据。方法选取100例2005-2007年内分泌专科就诊的GHD儿童垂体MRI资料,其中男74例,女26例;平均年龄为(8.82±3.68)岁。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,并比较其与临床的联系。结果在10～15岁GHD患儿头颅MRI检查垂体矢状高径明显优于其他各径线(P<0.01);在联合垂体功能缺陷(MPHD)中垂体后叶异位(EPP)的发生率(92.3%)显著高于GHD(7.7%,P<0.01)。结论对GHD儿童应重视头颅MRI检查,其垂体形态、结构的阳性发现可有助于临床疾病的诊断及鉴别诊断,必要时应随访MRI,结合临床综合判断诊治及其预后。

Objective To study the clinical value of MRI examination of the pituitary in children with growth hormone deficiency （GHD） and provide pathogenesis evidence of GHD. Methods MRI records of 100 GHD patients who were diagnosed in the Endocrinology Department of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine between 2005 and 2007 （including 74 boys and 26 girls, mean age was 8.82± 3.68） were studied. The configuration, size and signals of the pituitary gland were studied by cranial sagittal and coronal images at SE series T1WI. The relationship between MRI changes of the pituitary and clinical manifestation was analyzed. Results The height of the pituitary image in sagittal plane had clinical significance in diagnosis of GHD patients between 10 and 15 years. The incidence of eetopic posterior pituitary was significantly higher in combined pituitary hormone deficiency than that in GHD patients. Conclusions Children with GHD should have a cranial MRI scan as a part of their assessment. The particular configuration of the pituitary is helpful for diagnosis and differential diagnosis of pituitary diseases. Follow-up MRI study should be done if necessary and it might be useful for prognosis and treatment of GHD.