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Pituitary hypoplasia is the best MRI predictor of the severity and type of growth hormone deficiency in children with congenital growth hormone deficiency
Journal of Pediatric Endocrinology and Metabolism ( IF 1.3 ) Pub Date : 2021-07-01 , DOI: 10.1515/jpem-2021-0049
Himanshu Sharma 1 , Naincy Purwar 1 , Anshul Kumar 1 , Rahul Sahlot 1 , Umesh Garg 1 , Balram Sharma 1 , Sandeep Kumar Mathur 1
Affiliation  

Objectives Congenital idiopathic growth hormone deficiency (GHD) is associated with various MRI abnormalities, including sellar and extrasellar abnormalities. However, it remains contentious whether MRI brain findings could provide an additional avenue for precisely predicting the differentiation of GHD based on severity and type {isolated GHD or multiple pituitary hormone deficiencies (MPHD)}. This study aimed to ascertain the abnormality that is the best predictor of severity and type of GHD amongst the different MRI findings. Methods We conducted an analytical cross-sectional study, including 100 subjects diagnosed with idiopathic GHD. Patients were grouped into severe GHD, partial GHD, and MPHD and into groups based on the presence of pituitary hypoplasia, extrasellar brain abnormalities (EBA), and presence of ectopic posterior pituitary or pituitary stalk abnormalities (EPP/PSA) or both. Results Sixty six percentage of subjects had isolated GHD, 34% had MPHD, 71% had severe GHD, and 29% had partial GHD. Pituitary hypoplasia was the most common finding, observed in 53% of patients, while 23% had EBA, and 25% had EPP/PSA. Pituitary hypoplasia was observed to be the best predictor of severity of GHD with an odds ratio (OR) of 10.8, followed by EPP/PSA (OR=2.8), and EBA was the weakest predictor (OR=1.8). Pituitary hypoplasia was the only finding to predict MPHD (OR=9.2) significantly. On ROC analysis, a Pituitary height SDS of −2.03 had the best detection threshold for both severe GHD and MPHD. Conclusions We observed Pituitary hypoplasia to be not only the most frequent MRI abnormality but also the best predictor of severe GHD and MPHD amongst various sellar and extrasellar abnormalities.

中文翻译:

垂体发育不全是先天性生长激素缺乏症儿童生长激素缺乏症严重程度和类型的最佳MRI预测指标

目的 先天性特发性生长激素缺乏症 (GHD) 与各种 MRI 异常有关,包括鞍区和鞍区外异常。然而,MRI 大脑发现是否可以提供额外的途径来根据严重程度和类型(孤立的 GHD 或多种垂体激素缺乏症 (MPHD)} 精确预测 GHD 的分化,这仍然存在争议。本研究旨在确定在不同 MRI 发现中作为 GHD 严重程度和类型的最佳预测指标的异常。方法 我们进行了一项分析性横断面研究,包括 100 名诊断为特发性 GHD 的受试者。将患者分为严重 GHD、部分 GHD 和 MPHD,并根据垂体发育不全、鞍外脑异常 (EBA)、和存在异位垂体后叶或垂体柄异常 (EPP/PSA) 或两者兼而有之。结果 66% 的受试者患有孤立性 GHD,34% 患有 MPHD,71% 患有严重 GHD,29% 患有部分 GHD。垂体发育不全是最常见的发现,在 53% 的患者中观察到,而 23% 有 EBA,25% 有 EPP/PSA。垂体发育不全被观察到是 GHD 严重程度的最佳预测因子,优势比 (OR) 为 10.8,其次是 EPP/PSA (OR=2.8),EBA 是最弱的预测因子 (OR=1.8)。垂体发育不全是唯一能显着预测 MPHD (OR=9.2) 的发现。在 ROC 分析中,-2.03 的垂体高度 SDS 对严重 GHD 和 MPHD 具有最佳检测阈值。
更新日期:2021-07-07
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