ESPE Abstracts

This comprehensive literature review identified studies reporting MRI findings related to pituitary volume in children with GHD. Studies were selected for their relevance to clinical correlations involving short stature, GH peak levels, IGF-1 levels, and therapy response.

Results: The 30 studies reviewed highlight significant structural abnormalities in the pituitary gland of children GHD. Key findings include anterior pituitary hypoplasia, stalk agenesis, and ectopic posterior pituitary, as identified by Maghnie et al. These structural abnormalities are useful for diagnosing and prognosticating GHD and related conditions such as Combined Pituitary Hormone Deficiency (CPP), as shown by Brauner et al. The studies by Triulzi et al. and Zucchini et al. further confirmed the presence of ectopic posterior pituitary and hypoplasia in GHD patients. Bozzola et al. found that pituitary hypoplasia is more common in prepubertal children with isolated GHD (IGHD) and multiple pituitary hormone deficiencies (MPHD), correlating with lower GH peaks. Functional changes and clinical correlations were also noted across various studies. Kessler et al. reported that patients with IGHD had the lowest pituitary volumes (PV), with intermediate volumes in idiopathic short stature (ISS) patients and the highest in controls, highlighting PV's role in treatment response. Krasnow et al. identified greater cyst volume and POGO in GHD compared to ISS, while Kara et al. observed significant height increases post-treatment in GHD patients. Notably, Zhang Z et al. and Zhang F et al. linked reduced gray matter volume and regional homogeneity (ReHo) abnormalities to cognitive and motor deficits, emphasizing the broader neurological impact of GHD. Further research demonstrated that certain imaging characteristics could aid in managing GHD. For instance, Zhou Z et al. found that structural and functional brain changes correlate with IGF-1 levels and cognitive performance, while Oh JS et al. noted that pituitary volume is a reliable indicator of GHD severity and treatment response.

Discussion and Conclusion: Studies indicate significant associations between pituitary abnormalities and clinical outcomes such as short stature, GH peak levels, IGF-1 levels, and response to therapy. These findings underscore the critical role of MRI in diagnosing GHD, assessing its severity, and guiding therapeutic decisions.