Pituitary Imaging: Indications and Outcomes From a Tertiary Pediatric Center in the United Arab Emirates

TL;DR

This study examines MRI findings in children with pituitary-related endocrine issues, showing that MRI is effective in identifying structural abnormalities, especially in those with growth hormone deficiency.

Contribution

The study provides insights into the diagnostic yield of pituitary MRI in a pediatric population in the UAE, highlighting common structural findings.

Findings

Pituitary hypoplasia was observed in 54% of patients with confirmed growth hormone deficiency.

Rathke’s cleft cysts and interrupted pituitary stalk were identified in 4.4% and 2.4% of cases, respectively.

MRI combined with clinical and biochemical data improves diagnostic accuracy in pediatric endocrine evaluations.

Abstract

Introduction: The pituitary gland plays a critical role in regulating endocrine function, with disorders manifesting as diverse clinical and laboratory abnormalities. Magnetic resonance imaging (MRI) of the Sella turcica provides a detailed anatomical evaluation, supporting the diagnosis of pituitary pathologies, particularly growth hormone deficiency (GHD) and precocious puberty (PP).

Objectives: To describe the clinical, laboratory, and MRI characteristics of pediatric patients undergoing pituitary MRI at a tertiary pediatric center in the United Arab Emirates, and to estimate the diagnostic yield of MRI, defined as the frequency and pattern of structural pituitary abnormalities, across major endocrine indications.

Methodology: We conducted a retrospective review of 205 pediatric patients who underwent MRI Sella at Al Jalila Children’s Hospital, a major tertiary/quaternary pediatric hospital in Dubai, UAE, between January 2023 and June 2024. Data collected included demographics, auxological measurements (height, weight, BMI, bone age), laboratory results, and imaging findings.

Results: The cohort comprised 205 patients (130 (63.4%) male, mean age 10.0 years). Suspected GHD was the most common indication for MRI (165 patients, 80%), with 116 (56.5%) later confirmed. Pituitary hypoplasia was observed in 63 (54%) patients with GHD, while pituitary hyperplasia was noted in 5 (30%) cases of PP. Lesions such as Rathke’s cleft cysts (9, 4.4%) and interrupted pituitary stalk (5, 2.4%) were identified, predominantly in patients with GHD.

Conclusions: MRI sella provides anatomical characterization of the pituitary gland in children undergoing endocrine evaluation and demonstrates a range of structural findings, particularly among those with confirmed GHD. A comprehensive diagnostic approach combining imaging, auxological, and biochemical data enhances diagnostic accuracy.

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