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Pituitary Stalk and Ectopic Hyperintense T1 Signal on Magnetic Resonance Imaging: Implications for Anterior Pituitary Dysfunction

Pituitary Stalk and Ectopic Hyperintense T1 Signal on Magnetic Resonance Imaging: Implications... Abstract • Objective. —To determine if improved delineation of hypothalamic-pituitary neuroanatomy by magnetic resonance imaging, especially the posterior pituitary hyperintense T1 signal, can be correlated with anterior and posterior pituitary endocrine function. Design. —Children with ectopic posterior pituitary tissue were identified at the Endocrine Clinic of the Children's Hospital of Pittsburgh (Pa) and their records were reviewed. Participants.—Ten children with ectopic posterior pituitary tissue. Measurements. —Anterior pituitary hormone status, determined by standard testing, was correlated with the morphologic anomalies of the hypothalamic-pituitary region on magnetic resonance imaging. Results. —Patients were categorized by the appearance of the pituitary stalk based on the magnetic resonance image: attenuation of the stalk (group 1) or nonvisualization of the stalk (group 2). Patients in group 1 retained partial anterior pituitary function. Patients in group 2 had panhypopituitarism. Conclusion. —Prospective evaluation of affected individuals may provide insight into the pathophysiologic mechanisms of idiopathic hypopituitarism.(AJDC. 1993;147:647-652) References 1. Fujisawa I, Asato R, Nishimura K, et al. Anterior and posterior lobes of the pituitary gland: assessment by 1.5 T MR imaging . J Comput Assist Tomogr . 1987;11:214-220.Crossref 2. Kucharczyk J, Kucharczyk W, Berry I, et al. Histochemical characterization and functional significance of the hyperintense signal on MR images of the posterior pituitary . AJNR Am J Neuroradiol . 1988;9:1079-1083. 3. Brooks BS, El Gammal T, Allison JD, Hoffman WH. Frequency and variation of the posterior pituitary bright signal on MR images . AJNR Am J Neuroradiol . 1989;10:943-948. 4. Abrahams J. Ectopia of the posterior pituitary gland or lipoma? AJNR Am J Neuroradiol . 1991;12:579. 5. Fujisawa I, Kikuchi K, Nishimura K, et al. Transection of the pituitary stalk: development of an ectopic posterior lobe assessed with MR imaging . Radiology . 1987;165:487-489.Crossref 6. Root AW, Martinez CR, Muroff LR. Subhypothalamic high-intensity signals identified by magnetic resonance imaging in children with idiopathic anterior hypopituitarism: evidence suggestive of an 'ectopic' posterior pituitary gland . AJDC . 1989;143:366-367. 7. Werder EA, Zachmann M, Wichmann W, Valavanis A. Neurohypophyseal ectopy in growth hormone insufficiency . Horm Res . 1989;31:210-212.Crossref 8. Pellini C, diNatale B, De Angelis R, et al. Growth hormone deficiency in children: role of magnetic resonance imaging in assessing aetiopathogenesis and prognosis in idiopathic hypopituitarism . Eur J Pediatr . 1990;149: 536-541.Crossref 9. Brown RS, Bhatia V, Hayes E. An apparent cluster of congenital hypopituitarism in central Massachusetts: magnetic resonance imaging and hormonal studies . J Clin Endocrinol Metab . 1991;72:12-18.Crossref 10. Kuroiwa T, Okabe Y, Hasuo K, Yasumori K, Mizushima A, Masuda K. MR imaging of pituitary dwarfism . AJNR Am J Neuroradiol . 1991;12:161-164. 11. Maghnie M, Triulzi F, Larizza D, et al. Hypothalamic-pituitary dysfunction in growth hormone-deficient patients with pituitary abnormalities . J Clin Endocrinol Metab . 1991;73:79-83.Crossref 12. Yamanaka C, Momoi T, Fujisawa I, et al. Neurohypophyseal function of an ectopic posterior lobe in patients with growth hormone deficiency . Acta Endocrinol . 1990;122:664-670. 13. Kikuchi K, Fujisawa I, Ohie T, et al. Ectopic posterior lobe of the pituitary gland and intractable nocturnal enuresis in a case with pituitary dwarfism . Acta Paediatr Scand . 1989;78:479-481.Crossref 14. Fujisawa I, Nishimura K, Asato R, et al. Posterior lobe of the pituitary in diabetes insipidus: MR findings . J Comput Assist Tomogr . 1987;11:221-225.Crossref 15. Tien R, Kucharczyk J, Kucharczyk W. MR imaging of the brain in patients with diabetes insipidus . AJNR Am J Neuroradiol . 1991;12:533-542. 16. Kaufman BA, Kaufman B, Mapstone TB. Pituitary stalk agenesis: magnetic resonance imaging of 'ectopic posterior lobe' with surgical correlation . Pediatr Neurosci . 1988;14:140-144.Crossref 17. Fujisawa I, Asato R, Kawata M, et al. Hyperintense signal of the posterior pituitary on T1-weighted MR images: an experimental study . J Comput Assist Tomogr . 1989;13:371-377.Crossref 18. Kucharczyk W, Lenkinski RE, Kucharczyk J, Henkelman RM. The effect of phospholipid vesicles on the NMR relaxation of water: an explanation for the MR appearance of the neurohypophysis? AJNR Am J Neuroradiol . 1990;11:693-700. 19. Mark LP, Haughton VM, Hendrix LE, et al. High-intensity signals within the posterior pituitary fossa: a study with fat-suppression MR techniques . AJNR Am J Neuroradiol . 1991;12:529-532. 20. Scotti G, Triulzi F, Chiumello G, Dinatale B. New imaging techniques in endocrinology: magnetic resonance of the pituitary gland and sella turcica . Acta Paediatr Scand Suppl . 1989;356:5-14.Crossref 21. Root AW. Magnetic resonance imaging in hypopituitarism . J Clin Endocrinol Metab . 1991;72:10-11.Crossref 22. Kelly WM, Kucharczyk W, Kucharczyk J, et al. Posterior pituitary ectopia: an MR feature of pituitary dwarfism . AJNR Am J Neuroradiol . 1988;9: 453-460. 23. Gudinchet F, Brunelle F, Barth MO, et al. MR imaging of the posterior hypophysis in children . AJNR Am J Neuroradiol . 1989;10:511-514. 24. Abrahams JJ, Trefelner E, Boulware SD. Idiopathic growth hormone deficiency: MR findings in 35 patients . AJNR Am J Neuroradiol . 1991;12: 155-160. 25. Crowne EC, Shalet SM. Adult panhypopituitarism presenting as idiopathic growth hormone deficiency in childhood . Acta Pediatr Scand . 1991; 80:255-258.Crossref 26. Patel H, Tze WJ, Crichton JU, McCormick AQ, Robinson CC, Dolman CL. Optic nerve hypoplasia with hypopituitarism: septo-optic dysplasia with hypopituitarism . AJDC . 1975;129:175-180. 27. Roessmann U, Velasco ME, Small EJ, Hori A. Neuropathology of 'septo-optic dysplasia' (de Morsier syndrome) with immunohistochemical studies of the hypothalamus and pituitary gland . J Neuropathol Exp Neurol . 1987;46:597-608.Crossref 28. Schwanzel-Fukuda M, Bick D, Pfaff DW. Luteinizing hormone-releasing hormone (LHRH)-expressing cells do not migrate in an inherited hypogonadal (Kallmann) syndrome . Brain Res Mol Brain Res . 1989;6:311-326.Crossref 29. Adams JH, Daniel PM, Prichard MML. Changes in the hypothalamus associated with regeneration of the hypothalamo-neuro-hypophysial tract after pituitary stalk section in the ferret . J Comp Neurol . 1971;142:109-124.Crossref 30. El Gammal T, Brooks BS, Hoffman WH. MR imaging of the ectopic bright signal of posterior pituitary regeneration . AJNR Am J Neuroradiol . 1989;10:323-328. 31. Craft WH, Underwood LE, Van Wyk JJ. High incidence of perinatal insult in children with idiopathic hypopituitarism . J Pediatr . 1980;96:397.Crossref 32. Kikuchi K, Fujisawa I, Momoi T, et al. Hypothalamic-pituitary function in growth-hormone deficient patients with pituitary stalk transection . J Clin Endocrinol Metab . 1988;67:817-823.Crossref 33. Fujisawa I, Kikuchi K, Nishimura K, et al. Transection of the pituitary stalk: development of an ectopic posterior lobe assessed with MR imaging . Radiology . 1987;165:487-489.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Pituitary Stalk and Ectopic Hyperintense T1 Signal on Magnetic Resonance Imaging: Implications for Anterior Pituitary Dysfunction

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References (37)

Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1993.02160300053022
Publisher site
See Article on Publisher Site

Abstract

Abstract • Objective. —To determine if improved delineation of hypothalamic-pituitary neuroanatomy by magnetic resonance imaging, especially the posterior pituitary hyperintense T1 signal, can be correlated with anterior and posterior pituitary endocrine function. Design. —Children with ectopic posterior pituitary tissue were identified at the Endocrine Clinic of the Children's Hospital of Pittsburgh (Pa) and their records were reviewed. Participants.—Ten children with ectopic posterior pituitary tissue. Measurements. —Anterior pituitary hormone status, determined by standard testing, was correlated with the morphologic anomalies of the hypothalamic-pituitary region on magnetic resonance imaging. Results. —Patients were categorized by the appearance of the pituitary stalk based on the magnetic resonance image: attenuation of the stalk (group 1) or nonvisualization of the stalk (group 2). Patients in group 1 retained partial anterior pituitary function. Patients in group 2 had panhypopituitarism. Conclusion. —Prospective evaluation of affected individuals may provide insight into the pathophysiologic mechanisms of idiopathic hypopituitarism.(AJDC. 1993;147:647-652) References 1. Fujisawa I, Asato R, Nishimura K, et al. Anterior and posterior lobes of the pituitary gland: assessment by 1.5 T MR imaging . J Comput Assist Tomogr . 1987;11:214-220.Crossref 2. Kucharczyk J, Kucharczyk W, Berry I, et al. Histochemical characterization and functional significance of the hyperintense signal on MR images of the posterior pituitary . AJNR Am J Neuroradiol . 1988;9:1079-1083. 3. Brooks BS, El Gammal T, Allison JD, Hoffman WH. Frequency and variation of the posterior pituitary bright signal on MR images . AJNR Am J Neuroradiol . 1989;10:943-948. 4. Abrahams J. Ectopia of the posterior pituitary gland or lipoma? AJNR Am J Neuroradiol . 1991;12:579. 5. Fujisawa I, Kikuchi K, Nishimura K, et al. Transection of the pituitary stalk: development of an ectopic posterior lobe assessed with MR imaging . Radiology . 1987;165:487-489.Crossref 6. Root AW, Martinez CR, Muroff LR. Subhypothalamic high-intensity signals identified by magnetic resonance imaging in children with idiopathic anterior hypopituitarism: evidence suggestive of an 'ectopic' posterior pituitary gland . AJDC . 1989;143:366-367. 7. Werder EA, Zachmann M, Wichmann W, Valavanis A. Neurohypophyseal ectopy in growth hormone insufficiency . Horm Res . 1989;31:210-212.Crossref 8. Pellini C, diNatale B, De Angelis R, et al. Growth hormone deficiency in children: role of magnetic resonance imaging in assessing aetiopathogenesis and prognosis in idiopathic hypopituitarism . Eur J Pediatr . 1990;149: 536-541.Crossref 9. Brown RS, Bhatia V, Hayes E. An apparent cluster of congenital hypopituitarism in central Massachusetts: magnetic resonance imaging and hormonal studies . J Clin Endocrinol Metab . 1991;72:12-18.Crossref 10. Kuroiwa T, Okabe Y, Hasuo K, Yasumori K, Mizushima A, Masuda K. MR imaging of pituitary dwarfism . AJNR Am J Neuroradiol . 1991;12:161-164. 11. Maghnie M, Triulzi F, Larizza D, et al. Hypothalamic-pituitary dysfunction in growth hormone-deficient patients with pituitary abnormalities . J Clin Endocrinol Metab . 1991;73:79-83.Crossref 12. Yamanaka C, Momoi T, Fujisawa I, et al. Neurohypophyseal function of an ectopic posterior lobe in patients with growth hormone deficiency . Acta Endocrinol . 1990;122:664-670. 13. Kikuchi K, Fujisawa I, Ohie T, et al. Ectopic posterior lobe of the pituitary gland and intractable nocturnal enuresis in a case with pituitary dwarfism . Acta Paediatr Scand . 1989;78:479-481.Crossref 14. Fujisawa I, Nishimura K, Asato R, et al. Posterior lobe of the pituitary in diabetes insipidus: MR findings . J Comput Assist Tomogr . 1987;11:221-225.Crossref 15. Tien R, Kucharczyk J, Kucharczyk W. MR imaging of the brain in patients with diabetes insipidus . AJNR Am J Neuroradiol . 1991;12:533-542. 16. Kaufman BA, Kaufman B, Mapstone TB. Pituitary stalk agenesis: magnetic resonance imaging of 'ectopic posterior lobe' with surgical correlation . Pediatr Neurosci . 1988;14:140-144.Crossref 17. Fujisawa I, Asato R, Kawata M, et al. Hyperintense signal of the posterior pituitary on T1-weighted MR images: an experimental study . J Comput Assist Tomogr . 1989;13:371-377.Crossref 18. Kucharczyk W, Lenkinski RE, Kucharczyk J, Henkelman RM. The effect of phospholipid vesicles on the NMR relaxation of water: an explanation for the MR appearance of the neurohypophysis? AJNR Am J Neuroradiol . 1990;11:693-700. 19. Mark LP, Haughton VM, Hendrix LE, et al. High-intensity signals within the posterior pituitary fossa: a study with fat-suppression MR techniques . AJNR Am J Neuroradiol . 1991;12:529-532. 20. Scotti G, Triulzi F, Chiumello G, Dinatale B. New imaging techniques in endocrinology: magnetic resonance of the pituitary gland and sella turcica . Acta Paediatr Scand Suppl . 1989;356:5-14.Crossref 21. Root AW. Magnetic resonance imaging in hypopituitarism . J Clin Endocrinol Metab . 1991;72:10-11.Crossref 22. Kelly WM, Kucharczyk W, Kucharczyk J, et al. Posterior pituitary ectopia: an MR feature of pituitary dwarfism . AJNR Am J Neuroradiol . 1988;9: 453-460. 23. Gudinchet F, Brunelle F, Barth MO, et al. MR imaging of the posterior hypophysis in children . AJNR Am J Neuroradiol . 1989;10:511-514. 24. Abrahams JJ, Trefelner E, Boulware SD. Idiopathic growth hormone deficiency: MR findings in 35 patients . AJNR Am J Neuroradiol . 1991;12: 155-160. 25. Crowne EC, Shalet SM. Adult panhypopituitarism presenting as idiopathic growth hormone deficiency in childhood . Acta Pediatr Scand . 1991; 80:255-258.Crossref 26. Patel H, Tze WJ, Crichton JU, McCormick AQ, Robinson CC, Dolman CL. Optic nerve hypoplasia with hypopituitarism: septo-optic dysplasia with hypopituitarism . AJDC . 1975;129:175-180. 27. Roessmann U, Velasco ME, Small EJ, Hori A. Neuropathology of 'septo-optic dysplasia' (de Morsier syndrome) with immunohistochemical studies of the hypothalamus and pituitary gland . J Neuropathol Exp Neurol . 1987;46:597-608.Crossref 28. Schwanzel-Fukuda M, Bick D, Pfaff DW. Luteinizing hormone-releasing hormone (LHRH)-expressing cells do not migrate in an inherited hypogonadal (Kallmann) syndrome . Brain Res Mol Brain Res . 1989;6:311-326.Crossref 29. Adams JH, Daniel PM, Prichard MML. Changes in the hypothalamus associated with regeneration of the hypothalamo-neuro-hypophysial tract after pituitary stalk section in the ferret . J Comp Neurol . 1971;142:109-124.Crossref 30. El Gammal T, Brooks BS, Hoffman WH. MR imaging of the ectopic bright signal of posterior pituitary regeneration . AJNR Am J Neuroradiol . 1989;10:323-328. 31. Craft WH, Underwood LE, Van Wyk JJ. High incidence of perinatal insult in children with idiopathic hypopituitarism . J Pediatr . 1980;96:397.Crossref 32. Kikuchi K, Fujisawa I, Momoi T, et al. Hypothalamic-pituitary function in growth-hormone deficient patients with pituitary stalk transection . J Clin Endocrinol Metab . 1988;67:817-823.Crossref 33. Fujisawa I, Kikuchi K, Nishimura K, et al. Transection of the pituitary stalk: development of an ectopic posterior lobe assessed with MR imaging . Radiology . 1987;165:487-489.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jun 1, 1993

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