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{{Autoimmune polyendocrine syndrome}} | {{Autoimmune polyendocrine syndrome}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}{{Akshun}} | ||
==Overview== | ==Overview== | ||
Brain [[Magnetic resonance imaging|MRI]] may be helpful in the [[diagnosis]] of autoimmune polyendocrine syndrome associated [[hypopituitarism]] and [[hypogonadism]]. Findings on [[Magnetic resonance imaging|MRI]] suggestive of autoimmune polyendocrine syndrome include [[hypopituitarism]] and [[hypogonadism]]. [[Magnetic resonance imaging|MRI]] is the [[imaging]] procedure of choice in the [[diagnosis]] of [[Hypopituitarism (patient information)|hypopituitarism]]. It is preferred over the [[CT scan]] as [[optic chiasm]], [[pituitary stalk]], and [[cavernous sinuses]] can be seen in [[Magnetic resonance imaging|MRI]]. An [[Magnetic resonance imaging|MRI]] lesion needs to be related to clinical and lab findings. The absence of an [[Magnetic resonance imaging|MRI lesion]] mostly indicates a non-organic [[etiology]]. [[Autoantibodies]] against [[pituitary gland]] results in [[hemorrhage]] into the [[pituitary gland]] which presents as a high-intensity signal on both T1- and T2-weighted images. | |||
==MRI== | ==MRI== | ||
Brain [[Magnetic resonance imaging|MRI]] may be helpful in the [[diagnosis]] of autoimmune polyendocrine syndrome associated [[hypopituitarism]] and [[hypogonadism]]. Findings on [[MRI]] suggestive of autoimmune polyendocrine syndrome include [[hypopituitarism]] and [[hypogonadism]]. [[MRI]] in autoimmune polyendocrine syndrome may present with the following features:<ref name="Vance1994">{{cite journal|last1=Vance|first1=Mary Lee|title=Hypopituitarism|journal=New England Journal of Medicine|volume=330|issue=23|year=1994|pages=1651–1662|issn=0028-4793|doi=10.1056/NEJM199406093302306}}</ref><ref name="pmid20197674">{{cite journal |vauthors=Li G, Shao P, Sun X, Wang Q, Zhang L |title=Magnetic resonance imaging and pituitary function in children with panhypopituitarism |journal=Horm Res Paediatr |volume=73 |issue=3 |pages=205–9 |year=2010 |pmid=20197674 |doi=10.1159/000284363 |url=}}</ref><ref name="pmid21646285">{{cite journal |vauthors=Child CJ, Zimmermann AG, Woodmansee WW, Green DM, Li JJ, Jung H, Erfurth EM, Robison LL |title=Assessment of primary cancers in GH-treated adult hypopituitary patients: an analysis from the Hypopituitary Control and Complications Study |journal=Eur. J. Endocrinol. |volume=165 |issue=2 |pages=217–23 |year=2011 |pmid=21646285 |pmc=3132593 |doi=10.1530/EJE-11-0286 |url=}}</ref><ref name="Pozzi MucelliFrezza1992">{{cite journal|last1=Pozzi Mucelli|first1=R. S.|last2=Frezza|first2=F.|last3=Magnaldi|first3=S.|last4=Proto|first4=G.|title=Magnetic resonance imaging in patients with panhypopituitarism|journal=European Radiology|volume=2|issue=1|year=1992|pages=42–46|issn=0938-7994|doi=10.1007/BF00714180}}</ref><ref name="pmid22015494">{{cite journal |vauthors=Imashuku S, Kudo N, Kaneda S, Kuroda H, Shiwa T, Hiraiwa T, Inagaki A, Morimoto A |title=Treatment of patients with hypothalamic-pituitary lesions as adult-onset Langerhans cell histiocytosis |journal=Int. J. Hematol. |volume=94 |issue=6 |pages=556–60 |year=2011 |pmid=22015494 |doi=10.1007/s12185-011-0955-z |url=}}</ref><ref name="pmid7625990">{{cite journal |vauthors=De Herder WW, Lamberts SW |title=Imaging of pituitary tumours |journal=Baillieres Clin. Endocrinol. Metab. |volume=9 |issue=2 |pages=367–89 |year=1995 |pmid=7625990 |doi= |url=}}</ref> | |||
* | *[[Magnetic resonance imaging|MRI]] scan with [[intravenous]] [[gadolinium]] is the imaging procedure of choice in diagnosis of [[hypopituitarism]] . It is preferred over the [[CT scan]] as [[optic chiasm]], [[pituitary stalk]], and [[cavernous sinuses]] can be seen in [[Magnetic resonance imaging|MRI]]. | ||
*[[Magnetic resonance imaging|MRI]] <nowiki/>scan shows the following findings in cases of [[hypopituitarism]]: | |||
*[[Magnetic resonance imaging|MRI]]<nowiki/>scan shows the following findings in cases of [[hypopituitarism]]: | |||
**Decreased size of the [[pituitary gland]]. | **Decreased size of the [[pituitary gland]]. | ||
**[[Empty sella]] may be noticed in some cases. | **[[Empty sella]] may be noticed in some cases. | ||
| Line 44: | Line 18: | ||
**Mass may appear in the [[pituitary]]. | **Mass may appear in the [[pituitary]]. | ||
**[[Ectopic]] [[posterior lobe]] of the [[pituitary gland]] may be observed in cases of [[Pituitary dwarfism II|pituitary dwarfism]]. | **[[Ectopic]] [[posterior lobe]] of the [[pituitary gland]] may be observed in cases of [[Pituitary dwarfism II|pituitary dwarfism]]. | ||
**Infiltrative disorders such a sarcoidosis and histiocytosis may present as thickening of infundibulum | **Infiltrative disorders such a [[sarcoidosis]] and [[histiocytosis]] may present as thickening of infundibulum (hollow stalk that connects the [[hypothalamus]] and the posterior [[pituitary gland]]) | ||
**In cranial DI, T1 weighted | **In cranial DI, T1 weighted [[Magnetic resonance imaging|MRI]] shows absence of high intensity bright spot that is normally seen in posterior [[Pituitary gland|pituitary]]. | ||
*[[Magnetic resonance imaging|MRI]] is the single best imaging modality in the evaluation of [[Sella|sellar]] masses as certain findings are suggestive of some specific [[Sella turcica|sellar]] masses and help to differentiate them. | |||
*If [[Magnetic resonance imaging|MRI]] is not possible due to any reason, high-resolution [[Computed tomography|CT scan]] with contrast administration, in coronal plane, may be used as an alternative. | |||
*An [[magnetic resonance imaging]] ([[Magnetic resonance imaging|MRI]]) scan may show a three-dimensional image of [[pituitary gland]], [[hypothalamus]], and the [[organs]] near them. | |||
*[[Magnetic resonance imaging|MRI]] is used to detect the underlying cause of like the [[pituitary adenoma]] that can be seen as a mass with [[hormonal]] hypersecretion. | |||
*There is a positive [[correlation]] between [[Magnetic resonance imaging|MRI]] <nowiki/>findings and the number of [[Pituitary hormone|pituitary hormonal]] deficiencies. | |||
*An [[MRI]] lesion needs to be related to clinical and lab findings. The absence of an [[Magnetic resonance imaging|MRI]] lesion mostly indicates a non-organic [[etiology]]. | |||
==References== | ==References== | ||
Latest revision as of 13:52, 31 October 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]
Overview
Brain MRI may be helpful in the diagnosis of autoimmune polyendocrine syndrome associated hypopituitarism and hypogonadism. Findings on MRI suggestive of autoimmune polyendocrine syndrome include hypopituitarism and hypogonadism. MRI is the imaging procedure of choice in the diagnosis of hypopituitarism. It is preferred over the CT scan as optic chiasm, pituitary stalk, and cavernous sinuses can be seen in MRI. An MRI lesion needs to be related to clinical and lab findings. The absence of an MRI lesion mostly indicates a non-organic etiology. Autoantibodies against pituitary gland results in hemorrhage into the pituitary gland which presents as a high-intensity signal on both T1- and T2-weighted images.
MRI
Brain MRI may be helpful in the diagnosis of autoimmune polyendocrine syndrome associated hypopituitarism and hypogonadism. Findings on MRI suggestive of autoimmune polyendocrine syndrome include hypopituitarism and hypogonadism. MRI in autoimmune polyendocrine syndrome may present with the following features:[1][2][3][4][5][6]
- MRI scan with intravenous gadolinium is the imaging procedure of choice in diagnosis of hypopituitarism . It is preferred over the CT scan as optic chiasm, pituitary stalk, and cavernous sinuses can be seen in MRI.
- MRI scan shows the following findings in cases of hypopituitarism:
- Decreased size of the pituitary gland.
- Empty sella may be noticed in some cases.
- Pituitary stalk may be visible, thin, or totally absent.
- Posterior lobe of the pituitary may be absent.
- Mass may appear in the pituitary.
- Ectopic posterior lobe of the pituitary gland may be observed in cases of pituitary dwarfism.
- Infiltrative disorders such a sarcoidosis and histiocytosis may present as thickening of infundibulum (hollow stalk that connects the hypothalamus and the posterior pituitary gland)
- In cranial DI, T1 weighted MRI shows absence of high intensity bright spot that is normally seen in posterior pituitary.
- MRI is the single best imaging modality in the evaluation of sellar masses as certain findings are suggestive of some specific sellar masses and help to differentiate them.
- If MRI is not possible due to any reason, high-resolution CT scan with contrast administration, in coronal plane, may be used as an alternative.
- An magnetic resonance imaging (MRI) scan may show a three-dimensional image of pituitary gland, hypothalamus, and the organs near them.
- MRI is used to detect the underlying cause of like the pituitary adenoma that can be seen as a mass with hormonal hypersecretion.
- There is a positive correlation between MRI findings and the number of pituitary hormonal deficiencies.
- An MRI lesion needs to be related to clinical and lab findings. The absence of an MRI lesion mostly indicates a non-organic etiology.
References
- ↑ Vance, Mary Lee (1994). "Hypopituitarism". New England Journal of Medicine. 330 (23): 1651–1662. doi:10.1056/NEJM199406093302306. ISSN 0028-4793.
- ↑ Li G, Shao P, Sun X, Wang Q, Zhang L (2010). "Magnetic resonance imaging and pituitary function in children with panhypopituitarism". Horm Res Paediatr. 73 (3): 205–9. doi:10.1159/000284363. PMID 20197674.
- ↑ Child CJ, Zimmermann AG, Woodmansee WW, Green DM, Li JJ, Jung H, Erfurth EM, Robison LL (2011). "Assessment of primary cancers in GH-treated adult hypopituitary patients: an analysis from the Hypopituitary Control and Complications Study". Eur. J. Endocrinol. 165 (2): 217–23. doi:10.1530/EJE-11-0286. PMC 3132593. PMID 21646285.
- ↑ Pozzi Mucelli, R. S.; Frezza, F.; Magnaldi, S.; Proto, G. (1992). "Magnetic resonance imaging in patients with panhypopituitarism". European Radiology. 2 (1): 42–46. doi:10.1007/BF00714180. ISSN 0938-7994.
- ↑ Imashuku S, Kudo N, Kaneda S, Kuroda H, Shiwa T, Hiraiwa T, Inagaki A, Morimoto A (2011). "Treatment of patients with hypothalamic-pituitary lesions as adult-onset Langerhans cell histiocytosis". Int. J. Hematol. 94 (6): 556–60. doi:10.1007/s12185-011-0955-z. PMID 22015494.
- ↑ De Herder WW, Lamberts SW (1995). "Imaging of pituitary tumours". Baillieres Clin. Endocrinol. Metab. 9 (2): 367–89. PMID 7625990.