The assessment of the pituitary volume in normal prepubertal children with three-dimensional MRI

Year 2021, , 912 - 919, 30.09.2021

İlknur Okur Akşan , Ahmet Sarı

https://doi.org/10.17826/cumj.898454

Abstract

Purpose: The aim of the present study is to measure the pituitary volume of the children who are under 12 years of age with normal pituitary function and find the reference interval of the normal pituitary volume in the prepubertal period
Materials and Methods: A total 240 healthy children (120 boys- 120 girls) under the age of 12 yr who came our clinic for cranial MRI imaging for various indications within 2 years, were examined. The volume of pituitary gland was measured using a thin-section three dimensional magnetic resonance imaging (MRI) sequences of magnetization-prepared rapid gradient echo imaging with a 1-mm thick reconstructed sagittal images. We also examined the midline sagittal T1-weighted images for the measurement of the pituitary height
Results: The pituitary gland volume and height demonstrated increasing trend with the age for both genders in the prepubertal period. Although the pituitary volume in the neonatal period is higher in boys than in girls, it became opposite with the age of 6 yr. The height of the pituitary gland increases gradually-slowly with age; while it was higher in boys in the neonatal period, it was higher in girls at the age of 4 years. The lowest, highest and average values of the volume and height values of pituitary gland were found for each age and gender. The reference values of the pituitary volume values containing 5-10-25-50-75-90-95th percentiles were formed for each age and gender.
Conclusion: 3D MRI can be used for direct measurement of pituitary volume in prepubertal children. Measuring of pituitary volume using this 3D technique may permit a more precise assessment of the developing pituitary gland in children.

Keywords

prepubertal children, , pituitary gland volume 3D MRI

Normal prepubertal çocuklarda hipofiz hacminin üç boyutlu MRG ile değerlendirilmesi

Abstract

Amaç: Çalışmanın amacı normal hipofiz fonksiyonu olan 12 yaş altı kız ve erkeklerin hipofiz hacmini ölçmek ve prepubertal dönemde normal hipofiz hacminin referans aralığını bulmaktır.
Gereç ve Yöntem: İki yıl içinde çeşitli endikasyonlarla kraniyal MRG görüntülemesi için kliniğimize gelen, 12 yaş altı toplam 240 sağlıklı çocuk (120 erkek-120 kız) incelendi. Hipofiz bezi hacmi, 1 mm kalınlığındaki rekonstrükte sagittal imajlarla ince kesitli üç boyutlu mprage gradient eko MRG sekansları kullanılarak ölçüldü. Ayrıca hipofiz bezi yüksekliğinin ölçümü için orta hat sagital T1 ağırlıklı görüntüler inceledik.
Bulgular: Prepubertal dönemde her iki cinsiyet için hipofiz bezi hacmi ve yüksekliğinde yaşla birlikte artış gösterildi. Neonatal dönemde hipofiz hacmi erkeklerde kızlara göre daha yüksek olmasına ragmen; 6 yaşla bu tam tersi oldu. Hipofiz bezi yüksekliği yaşla kademeli-yavaş artış göstermekte olup; neonatal peryodda erkeklerde daha yüksekken 4 yaşla birlikte kızlarda daha yüksek olmuştur. Hipofiz bezinin hacim ve yükseklik değerlerinin en düşük, en yüksek ve ortalama değerleri her yaş ve cinsiyet için bulunmuştur. Her yaş ve cinsiyet için 5-10-25-50-75-90-95 persentil içeren hipofiz hacim değerlerinin referans değerleri oluşturulmuştur.
Sonuç: Prepubertal çocuklarda hipofiz hacminin doğrudan ölçümü için üç boyutlu MRG kullanılabilir. Bu 3 boyutlu teknik kullanarak hipofiz hacminin ölçümü, hipofiz bezi gelişiminin çocuklarda daha kesin bir şekilde değerlendirilmesine izin verebilir.

Keywords

: prepubertal çocuk, hipofiz bezi hacmi, üç boyutlu MRG

References

• Referans1- Bozzola M, Adamsbaum C, Biscaldi I, et al. Role of magnetic resonance imaging in the diagnosis and prognosis of growth hormone deficiency. J Clin Endocrinol. 1996; 45:21–26
• Referans2- Kornreich L, Horev G, Lazar L, et al. MR findings in growth hormone deficiency: correlation with severity of hypopituitarism. AJNR Am J Neuroradiol. 1998; 19:1495–1499
• Referans3- Bozzola M, Mengarda F, Sartirana P, et al. Long-term follow-up evaluation of magnetic resonance imaging in the prognosis of permanent GH deficiency. Eur J Endocrinol. 2000; 143:493–496
• Referans4- Suzuki M, Takashima T, Kayoda M, et all. Height of normal pituitary gland on MR imaging: age and sex differentiation. J Comput Assit Tomogr. 1990; 14:36–39
• Referans5- Elster AD, Chen MYM, Williams III DW, Key LL . Pituitary gland: MR imaging of physiologic hypertrophy in adolescence. Radiology. 1990; 174:681–685
• Referans6- Elster AD, Sanders TG, Vines FS, Chen MYM. Size and shape of the pituitary gland during pregnancy and post partum: measurement with MR imaging. Radiology. 1991; 181:531–535
• Referans7- Doraiswamy PM, Potts JM, Axelson DA, et all. MR Assessment of pituitary gland morphology in healthy volunteers: age and gender-related differences. AJNR Am J Neuroradiol. 1992; 13:1295–1299
• Referans8- Cox TD, Elster AD. Normal pituitary gland: changes in shape, size and signal intensity during the 1st year of life at MR imaging. Radiology. 1991; 179:721–724
• Referans9- Argyropoulou M, Perignon F, Brunelle F, Brauner R, Rappaport. Height of normal pituitary gland as a function of age evaluated by magnetic resonance imaging in children. Pediatr Radiol. 1991; 21:247–249
• Referans10- Tien RD, Kucharczyk J, Bessette J, Middleton M. MR imaging of the pituitary gland in infants and children: changes in size, shape, and MR signal with growth and development. AJR Am J Roentgenol. 1992; 158:1151–1154
• Referans11- Elster AD. Modern imaging of the pituitary. Radiology. 1993; 187:1Y14.
• Referans12- Lurie SN, Doraiswamy PM, Husain MM, et al. In vivo assessment of pituitary gland volume with magnetic resonance imaging: the effect of age. J Clin Endocrinol Metab. 1990; 71: 505–508
• Referans13- Peyster RG, Hoover ED, Viscarello RR, et al . CT appearance of the adolescent and preadolescent pituitary gland. AJNR Am J Neuroradiol. 1983; 4:411–414
• Referans14- Mc Lachlan MS, Williams ED, Fortt RW, et al. Estimation of pituitary gland dimension from radiographs of the sella turcica. A post mortem study. Br J Radiol. 1968; 41:323–330
• Referans15- Pikulev LA, Gerasimov SM, Cheremisin VM, et al . Relationship between the volume of the hypophysis and the volume of the sella turcica (radioanatomic study). Arkh. pat. anat. 1970; 59:98–104
• Referans16- Sharafuddin MJ, Luisiri A, Garibaldi LR, et al. MR imaging diagnosis of central precocious puberty: importance of changes in the shape and size of pituitary gland. AJNR Am J Neuroradiol . 1994; 162:1167–1173
• Referans17- Tsunoda A, Okuda O, Sato K. MR height of the pituitary gland as a function of age and sex: especially physiological hypertrophy in adolescence and in climacterium. AJNR Am J Neuroradiol. 1997; 18:551–554
• Referans18- Hamilton J, Blaser S, Daneman D . MR imaging in idiopathic growth hormone deficiency. AJNR Am J Neuroradiol. 1998; 19:1609–1615
• Referans19- Nagel B, Palmbach M, Petersen D, et al . Magnetic resonance images of 91 children with different causes of short stature: pituitary size reflects growth hormone secretion. Eur J Pediatr. 1997; 156:758–763
• Referans20- Takano K, Utsunomiya H, Ono H, Ohfu M, Okazaki M. Normal development of the pituitary gland: assessment with three-dimensional MR volumetry. AJNR Am J Neuroradiol. 1999 Feb; 20(2):312-5.
• Referans21- Marziali S, Gaudiello F, Bozzao A, et al. Evaluation of anterior pituitary gland volume in childhood using three-dimensional MRI. Pediatr Radiol. 2004 Jul; 34(7):547-51.
• Referans22- Fink AM, Vidmar S, Kumbla S, et al. Age-related pituitary volumes in prepubertal children with normal endocrine function: volumetric magnetic resonance data. J Clin Endocrinol Metab. 2005 Jun; 90(6):3274-8. Epub 2005 Mar 22.
• Referans23- Han X, Xiu J, Huang Z, et al. Three-dimensional magnetic resonance volumetry of the pituitary gland is effective in detecting short stature in children. Exp Ther Med. 2014 Aug; 8(2):551-556. Epub 2014 Jun 11.
• Referans24- Denk CC, Onderoğlu S, Ilgi S, Gürcan F. Height of normal pituitary gland on MRI: differences between age groups and sexes. Okajimas fol. anat. 1999; 6(2): 81-7