摘要
目的:探究垂体3.0T MRI成像联合生长激素(GH)诱发试验在儿童矮小症中的诊断价值。方法:以2019年7月~2021年7月146例矮小症患儿为研究组,并以同期83例性早熟患儿为对照组,均给予垂体3.0T MRI成像检查。分析垂体3.0T MRI成像对儿童矮小症及性早熟的鉴别价值;采用盐酸可乐定和精氨酸对矮小症患儿进行GH诱发试验,比较特发性矮小症(ISS)及生长激素缺乏症(GHD)患儿垂体3.0T MRI成像特征及GH诱发峰值,分析联合检查对ISS及GHD的鉴别价值;并分析不同垂体病变患儿的垂体3.0TMRI成像特征。结果:研究组的垂体冠状高径、冠状宽径、矢状前后径均短于对照组,垂体形态异常发生率高于对照组;垂体3.0T MRI成像特征联合检测鉴别矮小症及性早熟的AUC大于各成像特征单独检测;GHD组的垂体冠状高径、冠状宽径、矢状前后径均短于ISS组,垂体形态异常发生率高于ISS组,盐酸可乐定GHmax、精氨酸GHmax值均小于ISS组;联合检查鉴别ISS及GHD的AUC大于垂体3.0TMRI成像、GH诱发试验单独检查。146例矮小症患者中共检出65例垂体形态异常(垂体阻断综合征2例、垂体发育不良58例、空泡蝶鞍5例),检出率为44.52%。垂体阻断综合征表现为垂体前叶发育不良,垂体后叶T;WI高信号异位;垂体发育不良主要表现为垂体前叶薄小,高度小于正常值;空泡蝶鞍横断位T;WI、T;WI图像可见垂体窝处有类圆形脑脊液信号,且可见点状与脑组织等信号的垂体柄。结论:垂体3.0T MRI成像对矮小症具有诊断价值,且其联合GH诱发试验检查对ISS及GHD具有鉴别价值。
Objective To explore the diagnostic value of pituitary 3.0T MRI combined with growth hormone(GH)induction test in children with short stature.Methods A total of 146 children with short stature were enrolled as study group between July 2019 and July 2021,while other 83 children with precocious puberty during the same period were enrolled as control group.All underwent pituitary 3.0TMRI examination.The value of pituitary 3.0T MRI in the differential diagnosis of short stature and precocious puberty was analyzed.Clonidine hydrochloride and arginine were applied to conduct GH induction test for children with short stature.The pituitary 3.0T MRI characteristics and GH induction peak between children with idiopathic short stature(ISS)and those with growth hormone deficiency(GHD)were compared.The differential value of combined examination for ISS and GHD was analyzed.The pituitary 3.0T MRI characteristics in children with different pituitary lesions were analyzed.Results The coronal height-diameter,coronal width-diameter and sagittal anteroposterior diameter of pituitary in study group were shorter than those in control group,and incidence of abnormal pituitary morphology was higher than that in control group.AUC of combined detection with pituitary 3.0TMRI characteristics in the differential diagnosis of short stature and precocious puberty was greater than that of single imaging characteristic.The coronal height-diameter,coronal width-diameter and sagittal anteroposterior diameter of pituitary in GHD group were shorter than those in ISS group,incidence of abnormal pituitary morphology was higher than that in ISS group,GHmax values of clonidine hydrochloride and arginine were lower than those in ISS group.AUC of pituitary 3.0TMRI combined with GH induction test for distinguishing ISS from GHD was greater than that of them alone.In the 146 patients with short stature,there were 65 cases with abnormal pituitary morphology(2 cases with pituitary interruption syndrome,58 cases with pituitary dysplasia,5 cases with empty sella tarcica syndrome),with detection rate of 44.52%.Pituitary interruption syndrome was characterized by dysplasia of anterior pituitary and high signal ectopia of posterior pituitary on T;WI.Pituitary dysplasia was mainly manifested as thin and small anterior pituitary lobe,shorter than normal height.In empty sella tarcica syndrome,there were quasi-circular cerebrospinal fluid signal at pituitary fossa on transverse T;WI and T;WI images,and punctiform pituitary stalks with isointensity of brain tissues.Conclusion Pituitary 3.0T MRI is of diagnostic value for short stature.Pituitary 3.0T MRI combined with GH induction is of differential value for ISS and GHD.
作者
吴白龙
刘浩
王芷玥
叶晓琴
Wu Bai-long;Liu Hao;Wang Zhi-yue;Ye Xiao-qin(Bengbu Third Peopel’s Hospital,Bengbu 233000,China)
出处
《湖南师范大学学报（医学版）》
2021年第6期144-148,共5页
Journal of Hunan Normal University(Medical Sciences)
作者简介
通讯作者:吴白龙,E-mail:wubailong1315@163.com
