High-resolution heavily T2-weighted magnetic resonance imaging for evaluation of the pituitary stalk in children with ectopic neurohypophysis

Pediatr Radiol. 2017 May;47(5):599-605. doi: 10.1007/s00247-017-3784-2. Epub 2017 Mar 2.

Abstract

Background: In anterior pituitary deficiency, patients with non visible pituitary stalk have more often multiple deficiencies and persistent deficiency than patients with visible pituitary stalk.

Objective: To compare the diagnostic value of a high-resolution heavily T2-weighted sequence to 1.5-mm-thick unenhanced and contrast-enhanced sagittal T1-weighted sequences to assess the presence of the pituitary stalk in children with ectopic posterior pituitary gland.

Materials and methods: We retrospectively evaluated the MRI data of 14 children diagnosed with ectopic posterior pituitary gland between 2010 and 2014. We evaluated the presence of a pituitary stalk using a sagittal high-resolution heavily T2-weighted sequence and a 1.5-mm sagittal T1-weighted turbo spin-echo sequence before and after contrast medium administration.

Results: A pituitary stalk was present on at least one of the sequences in 10 of the 14 children (71%). T2-weighted sequence depicted the pituitary stalk in all 10 children, whereas the 1.5-mm-thick T1-weighted sequence depicted 2/10 (20%) before contrast injection and 8/10 (80%) after contrast injection (P=0.007).

Conclusion: Compared with 1.5-mm-thick contrast-enhanced T1-weighted sequences, high-resolution heavily T2-weighted sequence demonstrates better sensitivity in detecting the pituitary stalk in children with ectopic posterior pituitary gland, suggesting that contrast injection is unnecessary to assess the presence of a pituitary stalk in this setting.

Keywords: Child; Contrast agent; Ectopic neurohypophysis; Magnetic resonance imaging; Pituitary stalk.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Contrast Media
  • Female
  • Humans
  • Image Enhancement / methods
  • Infant
  • Magnetic Resonance Imaging / methods*
  • Male
  • Meglumine
  • Organometallic Compounds
  • Pituitary Diseases / diagnostic imaging*
  • Pituitary Gland, Posterior / abnormalities*
  • Pituitary Gland, Posterior / diagnostic imaging*
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • Organometallic Compounds
  • Meglumine
  • gadoterate meglumine