Pituitary stalk and ectopic hyperintense T1 signal on magnetic resonance imaging. Implications for anterior pituitary dysfunction.

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.

[1]  D. Larizza,et al.  Hypothalamic-pituitary dysfunction in growth hormone-deficient patients with pituitary abnormalities. , 1991, The Journal of clinical endocrinology and metabolism.

[2]  V. Haughton,et al.  High-intensity signals within the posterior pituitary fossa: a study with fat-suppression MR techniques. , 1991, AJNR. American journal of neuroradiology.

[3]  J. Kucharczyk,et al.  MR imaging of the brain in patients with diabetes insipidus. , 1991, AJNR. American journal of neuroradiology.

[4]  S. Shalet,et al.  Adult Panhypopituitarism Presenting as Idiopathic Growth Hormone Deficiency in Childhood , 1991, Acta paediatrica Scandinavica.

[5]  R. Brown,et al.  An apparent cluster of congenital hypopituitarism in central Massachusetts: magnetic resonance imaging and hormonal studies. , 1991, The Journal of clinical endocrinology and metabolism.

[6]  A. Root.  Magnetic resonance imaging in hypopituitarism. , 1991, Journal of Clinical Endocrinology and Metabolism.

[7]  S. Boulware,et al.  Idiopathic growth hormone deficiency: MR findings in 35 patients. , 1991, AJNR. American journal of neuroradiology.

[8]  A. Mizushima,et al.  MR imaging of pituitary dwarfism. , 1991, AJNR. American journal of neuroradiology.

[9]  W. Kucharczyk,et al.  Ectopia of the posterior pituitary gland or lipoma? , 1991, AJNR. American journal of neuroradiology.

[10]  R E Lenkinski,et al.  The effect of phospholipid vesicles on the NMR relaxation of water: an explanation for the MR appearance of the neurohypophysis? , 1990, AJNR. American journal of neuroradiology.

[11]  J. Konishi,et al.  Neurohypophyseal function of an ectopic posterior lobe in patients with growth hormone deficiency. , 1990, Acta endocrinologica.

[12]  J. Allison,et al.  Frequency and variation of the posterior pituitary bright signal on MR images. , 1989, AJR. American journal of roentgenology.

[13]  G. Scotti,et al.  New Imaging Techniques in Endocrinology: Magnetic Resonance of the Pituitary Gland and Sella Turcica , 1989, Acta paediatrica Scandinavica. Supplement.

[14]  J. Konishi,et al.  Ectopic Posterior Lobe of the Pituitary Gland and Intractable Nocturnal Enuresis in a Case with Pituitary Dwarfism , 1989, Acta Paediatrica Scandinavica.

[15]  K. Nakao,et al.  Hyperintense Signal of the Posterior Pituitary on T1‐weighted MR Images: An Experimental Study , 1989, Journal of computer assisted tomography.

[16]  F. Gudinchet,et al.  MR imaging of the posterior hypophysis in children. , 1989, AJR. American journal of roentgenology.

[17]  L. Muroff,et al.  Subhypothalamic high-intensity signals identified by magnetic resonance imaging in children with idiopathic anterior hypopituitarism. Evidence suggestive of an 'ectopic' posterior pituitary gland. , 1989, American journal of diseases of children.

[18]  B. Brooks,et al.  MR imaging of the ectopic bright signal of posterior pituitary regeneration. , 1989, AJNR. American journal of neuroradiology.

[19]  T. H. Newton,et al.  Histochemical characterization and functional significance of the hyperintense signal on MR images of the posterior pituitary. , 1988, AJR. American journal of roentgenology.

[20]  A. Valavanis,et al.  Neurohypophyseal ectopy in growth hormone insufficiency. , 1989, Hormone research.

[21]  J. Konishi,et al.  Hypothalamic-pituitary function in growth hormone-deficient patients with pituitary stalk transection. , 1988, The Journal of clinical endocrinology and metabolism.

[22]  T. H. Newton,et al.  Posterior pituitary ectopia: an MR feature of pituitary dwarfism. , 1988, AJNR. American journal of neuroradiology.

[23]  T. Mapstone,et al.  Pituitary stalk agenesis: magnetic resonance imaging of 'ectopic posterior lobe' with surgical correlation. , 1988, Pediatric neuroscience.

[24]  K. Togashi,et al.  Transection of the pituitary stalk: development of an ectopic posterior lobe assessed with MR imaging. , 1987, Radiology.

[25]  E. Small,et al.  Neuropathology of “Septo‐optic Dysplasia” (de Morsier Syndrome) with Immunohistochemical Studies of the Hypothalamus and Pituitary Gland , 1987, Journal of neuropathology and experimental neurology.

[26]  K. Togashi,et al.  Posterior Lobe of the Pituitary in Diabetes Insipidus: MR Findings , 1987, Journal of computer assisted tomography.

[27]  K. Togashi,et al.  Anterior and Posterior Lobes of the Pituitary Gland; Assessment by 1.5 T MR Imaging , 1987, Journal of computer assisted tomography.

[28]  J. V. Van Wyk,et al.  High incidence of perinatal insult in children with idiopathic hypopituitarism. , 1980, The Journal of pediatrics.

[29]  A. Mccormick,et al.  Optic nerve hypoplasia with hypopituitarism. Septo-optic dysplasia with hypopituitarism. , 1975, American journal of diseases of children.

[30]  P. Daniel,et al.  Changes in the hypothalamus associated with regeneration of the hypothalamo‐neurohypophysial tract after pituitary stalk section in the ferret , 1971, The Journal of comparative neurology.