Delayed puberty MRI: Difference between revisions

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==Overview==
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| [[image:Webp.net-gifmaker (35).gif|thumb|500px|Absent right olfactory bulb - Case courtesy of Dr Joseph Scheller, <ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/54233">rID: 54233</ref>]]
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[[Brain]] [[MRI]] is helpful in the diagnosis of delayed [[puberty]]. Findings on [[MRI]] suggestive of delayed [[puberty]] include [[Hypothalamus|hypothalamo]]-[[pituitary]] lesions, [[aplasia]] of [[olfactory bulb]] and/or [[Sulci (anatomy)|sulci]] ([[Kallmann syndrome]]), [[optic nerve]] compression ([[pituitary adenoma]]), and [[inner ear]] abnormalities ([[CHARGE syndrome]]). [[Aplasia]] of [[olfactory bulbs]] and/or [[Sulci (anatomy)|sulci]] in [[MRI]] is the main differentiation of [[Kallmann syndrome]] from isolated [[hypogonadotropic hypogonadism]], in the patient without smelling problems or hard to evaluate.
==Overview==
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[[Brain]] [[MRI]] may be helpful in the diagnosis of delayed [[puberty]]. Findings on [[MRI]] suggestive of delayed [[puberty]] include [[Hypothalamus|hypothalamo]]-[[pituitary]] lesions, [[aplasia]] of [[olfactory bulb]] and/or [[Sulci (anatomy)|sulci]] ([[Kallmann syndrome]]), [[optic nerve]] compression ([[pituitary adenoma]]), and [[inner ear]] abnormalities ([[CHARGE syndrome]]). Showing the [[aplasia]] of [[olfactory bulbs]] and/or [[Sulci (anatomy)|sulci]] in [[MRI]], it is assumed as differentiation of [[Kallmann syndrome]] from isolated [[hypogonadotropic hypogonadism]], in patient without smelling problems or hard to evaluate.
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==MRI==
==MRI==
* [[Brain]] [[MRI]] may be helpful in the diagnosis of delayed [[puberty]]. Findings on [[MRI]] suggestive of delayed [[puberty]] include:<ref name="pmid26194704">{{cite journal |vauthors=Boehm U, Bouloux PM, Dattani MT, de Roux N, Dodé C, Dunkel L, Dwyer AA, Giacobini P, Hardelin JP, Juul A, Maghnie M, Pitteloud N, Prevot V, Raivio T, Tena-Sempere M, Quinton R, Young J |title=Expert consensus document: European Consensus Statement on congenital hypogonadotropic hypogonadism--pathogenesis, diagnosis and treatment |journal=Nat Rev Endocrinol |volume=11 |issue=9 |pages=547–64 |year=2015 |pmid=26194704 |doi=10.1038/nrendo.2015.112 |url=}}</ref>
{| align="right"
| [[image:Webp.net-gifmaker (35).gif|thumb|480px|Absent right olfactory bulb - Case courtesy of Dr Joseph Scheller, via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/54233">rID: 54233</ref>]]
|}
* [[Brain]] [[MRI]] is helpful in the diagnosis of delayed [[puberty]]. Findings on [[MRI]] suggestive of delayed [[puberty]] include:<ref name="pmid26194704">{{cite journal |vauthors=Boehm U, Bouloux PM, Dattani MT, de Roux N, Dodé C, Dunkel L, Dwyer AA, Giacobini P, Hardelin JP, Juul A, Maghnie M, Pitteloud N, Prevot V, Raivio T, Tena-Sempere M, Quinton R, Young J |title=Expert consensus document: European Consensus Statement on congenital hypogonadotropic hypogonadism--pathogenesis, diagnosis and treatment |journal=Nat Rev Endocrinol |volume=11 |issue=9 |pages=547–64 |year=2015 |pmid=26194704 |doi=10.1038/nrendo.2015.112 |url=}}</ref>
** [[Hypothalamus|Hypothalamo]]-[[pituitary]] lesions
** [[Hypothalamus|Hypothalamo]]-[[pituitary]] lesions
** [[Aplasia]] of [[olfactory bulb]] and/or [[Sulci (anatomy)|sulci]] ([[Kallmann syndrome]])
** [[Aplasia]] of [[olfactory bulb]] and/or [[Sulci (anatomy)|sulci]] ([[Kallmann syndrome]])
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** [[Inner ear]] abnormalities ([[CHARGE syndrome]])
** [[Inner ear]] abnormalities ([[CHARGE syndrome]])
* [[Brain]] [[MRI]] is indicated in patients with delayed [[puberty]], experiencing some alarm signs, such as [[headache]], [[visual impairment]], and behavioral changes.
* [[Brain]] [[MRI]] is indicated in patients with delayed [[puberty]], experiencing some alarm signs, such as [[headache]], [[visual impairment]], and behavioral changes.
* Showing the [[aplasia]] of [[olfactory bulbs]] and/or [[Sulci (anatomy)|sulci]] in [[MRI]], it is assumed as differentiation of [[Kallmann syndrome]] from isolated [[hypogonadotropic hypogonadism]], in patient without smelling problems or hard to evaluate.<ref name="PalmertDunkel2012">{{cite journal|last1=Palmert|first1=Mark R.|last2=Dunkel|first2=Leo|title=Delayed Puberty|journal=New England Journal of Medicine|volume=366|issue=5|year=2012|pages=443–453|issn=0028-4793|doi=10.1056/NEJMcp1109290}}</ref>
* [[Aplasia]] of [[olfactory bulbs]] and/or [[Sulci (anatomy)|sulci]] in [[MRI]]<nowiki/>is the main differentiation of [[Kallmann syndrome]] from isolated [[hypogonadotropic hypogonadism]], in the patient without smelling problems or hard to evaluate.<ref name="PalmertDunkel2012">{{cite journal|last1=Palmert|first1=Mark R.|last2=Dunkel|first2=Leo|title=Delayed Puberty|journal=New England Journal of Medicine|volume=366|issue=5|year=2012|pages=443–453|issn=0028-4793|doi=10.1056/NEJMcp1109290}}</ref>
* A moderate agreement is seen between the smell identification test (UPSIT) and presence of the [[olfactory bulbs]] in [[MRI]], in patients with [[hypogonadotropic hypogonadism]]. While, there is a good agreement between them in absence of the [[olfactory bulbs]] in [[MRI]] and [[anosmia]].<ref name="pmid6694486">{{cite journal |vauthors=Doty RL, Shaman P, Kimmelman CP, Dann MS |title=University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic |journal=Laryngoscope |volume=94 |issue=2 Pt 1 |pages=176–8 |year=1984 |pmid=6694486 |doi= |url=}}</ref><ref name="PalmertDunkel2012" />
* In [[hypogonadotropic hypogonadism]], when the [[olfactory bulbs]] are absent in [[MRI]] the results of smell identification test (UPSIT) surely will show [[anosmia]]. While, when the [[olfactory bulbs]] are present in [[MRI]], UPSIT may or may not show anosmia.<ref name="pmid6694486">{{cite journal |vauthors=Doty RL, Shaman P, Kimmelman CP, Dann MS |title=University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic |journal=Laryngoscope |volume=94 |issue=2 Pt 1 |pages=176–8 |year=1984 |pmid=6694486 |doi= |url=}}</ref><ref name="PalmertDunkel2012" />
 
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<gallery align="left">
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image:Pituitary-adenoma-1.jpg|thumb|300px|Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16890">rID: 16890</ref>
image:Pituitary-adenoma-1.jpg|thumb|300px|Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16890">rID: 16890</ref>
image:Hypothalamic-hamartoma.jpeg|thumb|300px|Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16890">rID: 16890</ref>
image:Hypothalamic-hamartoma.jpeg|thumb|300px|Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16890">rID: 16890</ref>
image:Pituitary-macroadenoma-non-functioning-null-cell (1).jpg|thumb|300px|Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/5562">rID: 5562</ref>
image:Pituitary-macroadenoma-non-functioning-null-cell (1).jpg|thumb|300px|Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/5562">rID: 5562</ref>
image:Kallmann-syndrome25.jpg|thumb|300px|Kallman syndrome difference with normal brain - Case courtesy of A.Prof Frank Gaillard<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/6083">rID: 6083</ref>
image:Kallmann-syndrome25.jpg|thumb|300px|Kallman syndrome difference with normal brain - Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/6083">rID: 6083</ref>
</gallery>
</gallery>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 21:15, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

N7x5a4WCymE|500}}

Brain MRI is helpful in the diagnosis of delayed puberty. Findings on MRI suggestive of delayed puberty include hypothalamo-pituitary lesions, aplasia of olfactory bulb and/or sulci (Kallmann syndrome), optic nerve compression (pituitary adenoma), and inner ear abnormalities (CHARGE syndrome). Aplasia of olfactory bulbs and/or sulci in MRI is the main differentiation of Kallmann syndrome from isolated hypogonadotropic hypogonadism, in the patient without smelling problems or hard to evaluate.








MRI

Absent right olfactory bulb - Case courtesy of Dr Joseph Scheller, via Radiopaedia.org[1]




  • Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org[1]

    Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org[1]

  • Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org[1]

    Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org[1]

  • Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org[1]

    Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org[1]

  • Kallman syndrome difference with normal brain - Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org[1]

    Kallman syndrome difference with normal brain - Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org[1]

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Radiopaedia.org. From the case <"https://radiopaedia.org/cases/54233">rID: 54233
  2. ↑ Boehm U, Bouloux PM, Dattani MT, de Roux N, Dodé C, Dunkel L, Dwyer AA, Giacobini P, Hardelin JP, Juul A, Maghnie M, Pitteloud N, Prevot V, Raivio T, Tena-Sempere M, Quinton R, Young J (2015). "Expert consensus document: European Consensus Statement on congenital hypogonadotropic hypogonadism--pathogenesis, diagnosis and treatment". Nat Rev Endocrinol. 11 (9): 547–64. doi:10.1038/nrendo.2015.112. PMID 26194704.
  3. ↑ 3.0 3.1 Palmert, Mark R.; Dunkel, Leo (2012). "Delayed Puberty". New England Journal of Medicine. 366 (5): 443–453. doi:10.1056/NEJMcp1109290. ISSN 0028-4793.
  4. ↑ Doty RL, Shaman P, Kimmelman CP, Dann MS (1984). "University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic". Laryngoscope. 94 (2 Pt 1): 176–8. PMID 6694486.

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