生长激素缺乏症的患儿垂体MRI改变与临床关系探讨  

The relationship between MRI findings of pituitary gland and clinical features in children with Growth hormone deficiency disease

作　　者：刘源[1] 李倩[2] 郑晓静[3] 倪娟 常光辉[4] 安洪庆[2] 任宝芹 刘长云[2] LIU Yuan;LI Qian;ZHENG Xiaojing;NI Juan;CHANG Guanghui;AN Hongqing;REN Baoqin;LIU Changyun(Department of Internal Medicine,Affiliated Hospital of Weifang Medical University,Weifang 261032,China;Department of Pediatrics,Clinical Medical College,Weifang Medical University,Weifang 261041,China;Department of Pediatrics,Affiliated Hospital of Weifang Medical University,Weifang 261032,China;Department of Imaging Center,Affiliated Hospital of Weifang Medical University,Weifang 261032,China)

机构地区：[1]潍坊医学院附属医院内科,山东潍坊261032 [2]潍坊医学院临床学院儿科教研室,山东潍坊261041 [3]潍坊医学院附属医院儿科,山东潍坊261032 [4]潍坊医学院附属医院影像中心,山东潍坊261032

出　　处：《医学影像学杂志》2023年第10期1755-1759,共5页Journal of Medical Imaging

基　　金：山东省自然科学基金项目(编号:ZR2016HL45)。

摘　　要：目的探讨生长激素缺乏(GHD)矮小症的垂体MRI特点与疾病的关系,了解生长激素(GH)激发峰值对矮小症的垂体诊断及预判,分析垂体发育的影像表现和矮小症的关系。方法选取我院儿科诊断为CHD矮小症的92例患者儿为观察组,选择同期健康查体的正常儿童65例为对照组,两组一般资料比较差异无统计学意义(P>0.05)。两组受试者行头颅冠状位、矢状位T 1WI序列及轴位T 2WI序列扫描。GH激发试验采用溴吡斯的明与可乐定联合,用药后30、60、90、120 min分别采静脉血1 ml测GH水平,GH峰值≥10μg/L正常,GH峰值5~10μg/L为部分缺乏,GH峰值<5μg/L为完全缺乏。应用SPSS 25.0软件进行统计学分析。结果观察组92例中MRI垂体形态、信号表现未见异常59例(64.1%),垂体高径为3.0~6.5 mm;垂体形态及信号表现异常33例(35.9%);其中垂体腺瘤4例(4.3%,包括垂体微腺瘤2例);小垂体15例(16.3%);空泡蝶鞍2例(2.2%);垂体柄异常改变(变细、扭曲、饱满)5例(5.4%);垂体肿瘤6例(6.5%),颅咽管瘤1例(1.0%),在MRI扫描垂体异常的33例中,GH峰值<5μg/L(完全缺乏)26例(78.8%),GH峰值5~10μg/L(部分缺乏)7例(21.2%)。结论GHD患儿垂体MRI扫描可以多方位、立体的展示垂体的正常形态和器质性病变,为临床早期诊断GHD性垂体病变导致的身材矮小症具有极其重要的应用价值。Objective To investigate the relationship between pituitary MRI features and growth hormone deficiency(GHD)dwarfism,to understand the pituitary diagnosis and prediction of GHD by the peak value of GH stimulation,and to analyze the relationship between pituitary imaging and GHD.Methods A retrospective analysis was performed on 92 patients diagnosed with growth hormone deficiency short stature in pediatric outpatient department of our hospital as observation group.A total of 65 healthy children who underwent physical examination during the same period were selected as the control group.There was no significant difference in general information between the two groups(P<0.05).The 3.0 T magnetic resonance scanner produced by Siemens in Germany was used to scan the coronal,sagittal and axial T 1WI sequences of the head of all the children.Growth hormone stimulation test was performed by the combination of brompyristine and clonidine.One ml of venous blood was collected at 30 min,60 min,90 min and 120 min after treatment to measure GH level,respectively.GH peak≥10μg/L was normal,GH peak 5~10μg/L was partially deficient,GH peak less than 5μg/L was completely deficient.SPSS 25.0 software was used for statistical analysis.Results Among 92 cases,59 cases(64.1%)showed normal pituitary shape and signal,the height of pituitary was 3.0~6.5 mm,33 cases(35.9%)showed abnormal pituitary shape and signal.There were 4(4.3%)pituitary adenomas including 2 patients with pituitary microadenomas,15(16.3%)patients with hypoplasia,2(2.2%)patients with vacuolated sella,5 cases(5.4%)had abnormal changes of pituitary stalk,6 cases(6.5%)had pituitary tumor and 1 case(1.0%)had craniopharyngioma.Among 33 cases of pituitary abnormalities,26 cases(78.8%)had a peak value of less than 5μg/L(com-plete deficiency),and 7 cases(21.2%)had a peak value of 5~10μg/L(incomplete deficiency).Conclusion MRI scan of pituitary in children with GHD can display the normal shape and organic pathological changes of pituitary in many directions and three dimensi

关 键 词：垂体 磁共振成像 儿童 矮小症 

分 类 号：R548.2[医药卫生—心血管疾病] R445.2[医药卫生—内科学]