MODERN IMAGING TECHNIQUES IN GH SECRETORY DISORDERS

Magnetic resonance images of the pituitary-hypothalamic area in patien ts with GH secretory disorders, divided into two groups (hypersecretor y and hyposecretory), were studied. In the first group there were 42 p atients with pituitary adenoma; size, signal characteristics, directio n of growth, and type of enhancement were analyzed and compared with s imilar studies in 40 age and sex matched control patients with non-GH secreting pituitary adenomas. No significant differences were found ex cept for a higher frequency of chiasm involvement and a more pronounce d contrast enhancement in the control group. The hyposecretory group w as composed of 101 patients with congenital idiopathic growth hormone deficiency (CIGHD). MR revealed morphological abnormalities consisting of hypoplastic anterior pituitary and ectopic posterior pituitary (PP E) in 59 patients, without evidence of a complete pituitary stalk; in 42 patients the posterior pituitary was in normal position and the pit uitary stalk visible. The group with PPE showed a greater frequency of multiple pituitary hormone deficiency (51% vs 12%), breech delivery ( 30% vs 7%) and associated congenital brain anomalies (12% vs 7%). Thes e data suggest that CIGHD could be the result of a congenital midline brain anomaly in a significant proportion of patients.