Introduction: Ectopic posterior pituitary (EPP) is a malformation of the hypothalamic-pituitary region presented as a spectrum from isolated growth hormone deficiency (GHD) to multiple pituitary hormone deficiencies (MPHD). Our goal was to establish whether the FAST1.2 protocol, which combines FAST1 protocol with 3D-T2DRIVE images, could identify the pituitary stalk (PS) and the regional anatomy more accurately. Methods: A retrospective study of 36 individuals with EPP and hypopituitarism, and a control group of 78 individuals with eutopic posterior pituitary. All individuals were submitted to FAST1.2. The position and size of the pituitary lobes were described, and the presence/absence of the PS was confirmed. Results: FAST1 identified the PS in 19% of individuals with EPP, while FAST1.2 identified the PS in 67% (p<0.001). In the FAST1.2 protocol, the PS was visible in all control individuals. All EPP patients with isolated GHD had visible PS in FAST1.2, while only 58,6% of MPHD cases had visible PS. The size of the anterior lobe and the anteroposterior length of the posterior pituitary were smaller in the EPP group vs controls (p<0.001). We noticed a reduced anterior pituitary lobe in both diameters in MPHD patients (p<0.05). Six patients acquired new pituitary hormone deficiencies not recognized at the time of MRI, in this group only one patient had a PS not visible in FAST1.2. Discussion/Conclusion: The FAST1.2 protocol could prevent the misdiagnosis of idiopathic GHD in patients with short stature and could also be important in the progression to MPHD. The PS could be considered a predictor of hypopituitarism, but its use as an isolated indicator for the progression to MPHD is not recommended. Our results reinforce the use of the size of the anterior lobe as a predictor of hypopituitarism and a possible predictor of the degree of pituitary insufficiency FAST1.2 protocol could be used as an alternative to gadolinium administration, as a cheaper and faster method, while eliminating the potential risks associated with the administration of contrast media.


中文翻译：

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将 T2 加权图像添加到 FAST1 协议以评估下丘脑-垂体区域的解剖结构

简介：异位垂体后叶 (EPP) 是一种下丘脑-垂体区域的畸形，表现为从孤立的生长激素缺乏症 (GHD) 到多种垂体激素缺乏症 (MPHD)。我们的目标是确定将 FAST1 协议与 3D-T2DRIVE 图像相结合的 FAST1.2 协议是否可以更准确地识别垂体柄 (PS) 和区域解剖结构。方法：回顾性研究 36 例 EPP 和垂体功能减退患者，对照组 78 例垂体后叶在位患者。所有个人都提交给 FAST1.2。描述了垂体叶的位置和大小，并确认了 PS 的存在/不存在。结果：FAST1 在 19% 的 EPP 患者中鉴定出 PS，而 FAST1.2 在 67% 中鉴定出 PS（p<0.001）。在 FAST1 中。2协议，PS在所有对照个体中可见。所有孤立性 GHD 的 EPP 患者在 FAST1.2 中都有可见的 PS，而只有 58.6% 的 MPHD 病例有可见的 PS。与对照组相比，EPP 组的前叶大小和垂体后叶前后长度更小（p<0.001）。我们注意到 MPHD 患者两个直径的垂体前叶减少（p<0.05）。6 名患者出现 MRI 时未发现的新垂体激素缺乏症，在该组中只有一名患者的 PS 在 FAST1.2 中不可见。讨论/结论：FAST1.2 方案可以防止身材矮小患者的特发性 GHD 误诊，并且对于 MPHD 的进展也很重要。PS可以被认为是垂体功能减退的预测因子，但不推荐将其用作 MPHD 进展的独立指标。我们的结果强化了使用前叶大小作为垂体功能减退的预测因子和垂体功能不全程度的可能预测因子 FAST1.2 方案可用作钆给药的替代方法，作为一种更便宜、更快捷的方法，同时消除与使用造影剂相关的潜在风险。