High-resolution heavily T2-weighted magnetic resonance imaging for evaluation of the pituitary stalk in children with ectopic neurohypophysis

Sanharawi, Imane El; Tzarouchi, Loukia; Cardoen, Liesbeth; Léger, Juliane; Carel, Jean‐Claude; Elmaleh‐Bergès, Monique; Alison, Marianne

doi:10.1007/s00247-017-3784-2

Cited by 9 publications

(7 citation statements)

References 26 publications

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“…Even though the FAST1 protocol can be very useful as an initial step in the diagnosis of GHD, it is not appropriate for characterizing the PS, as it limits the interpretation and recognition of MPHD patients, making intravenous gadolinium-based contrast administration the current adopted gold standard protocol for this evaluation. El Sanharawi et al [6], for example, evaluated the presence of the PS in 14 patients using MRI with gadolinium-based contrast and T2-weighted sequences, with a good correlation between groups, although no control group was included in the study.…”

Section: Discussionmentioning

confidence: 99%

“…The sagittal sequence in FAST1 was obtained according to previously reported parameters [4], and an additional 3D T2 DRIVE sequence (TR∕TE 1,500∕250 ms) lasting 3 min and 37 s obtained 40 slices in the sagittal plane with a thickness of 0.6 mm. All patients were in fluid restriction for at least 6 h for adequate visualization of the neurohypophysis hypersignal [6]. The images were analyzed by a neuroradiologist (A.J.R.)…”

Section: Methodsmentioning

confidence: 99%

“…However, the PS is not precisely defined on FAST1, particularly when it is thin or absent, requiring in some instances gadolinium administration or complementation with T2-weighted sequences (CISS, DRIVE, or FI-ESTA) to accurately reveal the spectrum of involvement [5,6]. Intravenous gadolinium administration has long been considered safe when administered at recommended doses in the absence of contraindications [7].…”

Section: Introductionmentioning

confidence: 99%

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Adding T2-Weighted Images to FAST1 Protocol to Evaluate the Anatomy of the Hypothalamic-Pituitary Region

et al. 2022

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adding T2-Weighted Images to FAST1 Protocol to Evaluate the Anatomy of the Hypothalamic-Pituitary Region

et al. 2022

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“…However, the T1 MRI sagittal sequence pattern is not able to perfectly detect small changes in the pituitary stalk. To do this, it is necessary to perform a T1 weighted sequence with gadolinium administration or the T2-weighted sequences (T2 weighted images with very thin slices preferably using 3D acquisition sequences, which are named differently according to the manufacturer (CISS, DRIVE, or FIESTA) [6,7]. Therefore, we started assessing patients with EPP using the FAST1.2 protocol, which consists of FAST1 with the addition of T2 DRIVE acquisition.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, we started assessing patients with EPP using the FAST1.2 protocol, which consists of FAST1 with the addition of T2 DRIVE acquisition. [6,7] This new FAST1.2 protocol provides detailed information on the anatomy of the suprasellar compartment, as a result of differences between the cerebrospinal uid and the adjacent parenchymal structures. The images allow an accurate assessment of the pituitary stalk while avoiding the use of intravenous contrast administration and therefore maintaining the major characteristic of the FAST1 protocol, namely its short duration protocol, with the new method taking less than 7 minutes when using a 1.5 Tesla MR scanner.…”

Section: Introductionmentioning

confidence: 99%

Extra pituitary midline structural abnormalities associated with ectopic posterior pituitary detected on a new rapid MR protocol (FAST1.2)

Lyra

Guimarães

Meira

et al. 2021

Preprint

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Background Ectopic posterior pituitary (EPP) is a malformation of the hypothalamic-pituitary region. Our goal was to describe midline structural brain abnormalities in patients with EPP using a dedicated protocol (FAST1.2 protocol) of magnetic resonance imaging (MRI) to evaluate the hypothalamus and pituitary gland, highlighting their clinical-laboratory correlations. Methods A cross-sectional study of patients diagnosed with EPP, and a control group. All individuals were submitted to a dedicated MRI protocol called FAST1.2, which combines the FAST1 protocol developed by our group with 3D T2DRIVE imaging. Results We evaluated 36 individuals with EPP and 78 individuals as a control group. One patient had two posterior pituitary lobes, one inside the sella turcica and the other along the pituitary stalk; in five patients, the EPP was along the pituitary stalk; in 28 the EPP was at the infundibular recess of the third ventricle, and in two the EPP was hypothalamic. In the EPP group, eleven individuals had interhypothalamic adhesion (IHA), three septo-optic dysplasia, one a cerebellar malformation, and one a pineal cyst. We did not observe a higher frequency of severe hormonal deficiency or developmental delay in patients with IHA. In the control group, eleven patients had a pineal cyst, three pars intermedia cysts, one hydrocephalus, and one hypothalamic hamartoma. Conclusion FAST1.2 acquisition allows confident recognition of regional anatomy and recognition of midline structural abnormalities on T2DRIVE, particularly including the pituitary stalk and IHA, thereby making MRI acquisition faster with no need for intravenous contrast administration. We suggest that IHA could be associated with defects in neuronal migration, as might occur in patients with EPP.

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A new imaging entity consistent with partial ectopic posterior pituitary gland: report of six cases

et al. 2019

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High-resolution heavily T2-weighted magnetic resonance imaging for evaluation of the pituitary stalk in children with ectopic neurohypophysis

Cited by 9 publications

References 26 publications

Adding T2-Weighted Images to FAST1 Protocol to Evaluate the Anatomy of the Hypothalamic-Pituitary Region

Adding T2-Weighted Images to FAST1 Protocol to Evaluate the Anatomy of the Hypothalamic-Pituitary Region

Extra pituitary midline structural abnormalities associated with ectopic posterior pituitary detected on a new rapid MR protocol (FAST1.2)

A new imaging entity consistent with partial ectopic posterior pituitary gland: report of six cases

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