Delayed puberty MRI
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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
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Brain MRI may be 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). Showing the aplasia of olfactory bulbs and/or sulci in MRI, it is assumed as differentiation of Kallmann syndrome from isolated hypogonadotropic hypogonadism, in the patient without smelling problems or hard to evaluate.
MRI
- Brain MRI may be helpful in the diagnosis of delayed puberty. Findings on MRI suggestive of delayed puberty include:[2]
- Hypothalamo-pituitary lesions
- Aplasia of olfactory bulb and/or sulci (Kallmann syndrome)
- Optic nerve compression (pituitary adenoma)
- 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.
- Showing the aplasia of olfactory bulbs and/or sulci in MRI, it is assumed as differentiation of Kallmann syndrome from isolated hypogonadotropic hypogonadism, in the patient without smelling problems or hard to evaluate.[3]
- In patients with hypogonadotropic hypogonadism, when the olfactory bulbs are absent in MRI the results of smell identification test (UPSIT) surely show anosmia. But with presence of olfactory bulbs in MRI, UPSIT may or may not conclude anosmia in patients.[4][3]
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Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard[1]
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Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard[1]
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Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard[1]
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Kallman syndrome difference with normal brain - Case courtesy of A.Prof Frank Gaillard[1]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Radiopaedia.org. From the case <"https://radiopaedia.org/cases/54233">rID: 54233
- ↑ 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.
- ↑ 3.0 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.
- ↑ 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.