CONTRIBUTION OF MAGNETIC-RESONANCE-IMAGIN G TO THE EVALUATION OF NONNEOPLASTIC HYPOTHALAMOPITUITARY DISORDERS

This study was designed to evaluate the diagnostic, therapeutic, and p athogenetic data provided by magnetic resonance imaging (MRI) in nonne oplastic hypothalamo-pituitary disorders. After determination of age-s pecific pituitary heights, 46 children with idiopathic growth hormone deficiency (GH peak < 8 ng/ml) were studied. Twenty-nine patients (gro up I) had pituitary stalk interruption syndrome and 17 (group II) had no anatomic abnormalities. Age-specific pituitary height was decreased by more than 2 SDs in all group I patients versus only 60% (10/17) of group II patients. The GH deficiency was transient in 4 of the 7 chil dren with normal pituitary findings. Forty-seven girls with breast dev elopment before eight years of age were also studied : age-specific pi tuitary height was normal in all girls with premature thelarche and 68 % of girls with mild form of central precocious puberty (CPP). Conver sely, in 70 % of girls with evolutive CPP, age-specific pituitary heig ht was increased by more than 2 SDs. These data show that MRI is usefu l for the diagnosis of pituitary insufficiency and that multiple anter ior pituitary deficiencies can be expected in patients with anatomic a bnormalities. MRI is of diagnostic and prognostic usefulness in CPP an d, therefore, is of assistance in making therapeutic decisions.