Prevalence and Degree of Structural Changes in Children with Growth Hormone Deficiency: A Comparative Review with Idiopathic Short Stature

Ashraf Soliman; Fawzia Alyafei; Nada Alaaraj; Shayma Ahmed; Noora AlHemedi; Ahmed Elawwa

Introduction: This chronological review of MRI studies from 1991 to 2024 ims to summarize the prevalence and degree of MRI-detected structural changes in GHD patients and compare these findings with children having Idiopathic Short Stature (ISS).

Methods: Data were extracted from various studies, highlighting key changes and comparisons with ISS.

Results: Studies consistently show significant MRI-detected structural changes in children with GHD, including:


Author(s)	Findings
Maghnie et al. (1991)	Anterior pituitary hypoplasia, stalk agenesis, and ectopic posterior pituitary
Brauner et al. (1993), Triulzi et al. (1994), Avataneo et al. (1994), Zucchini et al. (1995)	MRI useful for diagnosis and prognosis, showing ectopia of posterior pituitary and hypoplasia in GHD
Bozzola et al. (1996)	66% prevalence in prepubertal, 18% in pubertal patients, with pituitary hypoplasia more common in prepubertal IGHD and MPHD
Czernichow et al. (2000)	54% prevalence with pituitary stalk thickening
Binder et al. (2002)	MRI morphology suggests GH-1 gene mutations in IGHD type II
Di Iorgi et al. (2012)	MRI abnormalities correlated with MPHD and persistent GHD
Maghnie et al. (2013)	26.8% abnormal MRIs with severe characteristics linked to abnormal MRI
Deeb et al. (2015)	Pituitary volume useful marker for diagnosing IGHD
Kessler et al. (2016)	Significant differences in pituitary volume (PV) among IGHD, ISS, and controls
Krasnow et al. (2018)	Greater pituitary cyst volume and POGO in GHD vs ISS
Kara et al. (2018)	Pathological evidence in 16.4% of patients, significant height increase post-treatment
Hu et al. (2019)	FCD differences in brain networks between GHD and ISS
Zhang et al. (2020, 2021)	Significant morphological changes in IGHD compared to ISS, smaller gray matter volume
Ding et al. (2024), Zhang et al. (2021), Zhou et al. (2023)	Structural and functional brain changes in GHD correlating with cognitive deficits and IGF-1 levels

Discussion: The review underscores the significant prevalence of structural changes in children with GHD, detected via MRI, ranging from anterior pituitary hypoplasia to differences in brain network activities. Comparisons with ISS reveal intermediate structural changes. Early studies focused on structural anomalies, while recent research has detailed functional analyses, correlating changes with clinical and cognitive outcomes.

Conclusion: MRI is critical in diagnosing and understanding structural and functional changes in children with GHD. The prevalence and degree of these changes vary, highlighting MRI's importance in clinical evaluations. Comparisons with ISS emphasize MRI's diagnostic capabilities, aiding accurate diagnosis and effective treatment planning for GHD children.

ESPE Abstracts

P3-325