中国医学科学院学报2012，Vol.34Issue(5)：468-473,6.DOI:10.3881/j.issn.1000-503X.2012.05.006
原发性甲状腺功能减退症伴垂体增生患者的磁共振成像表现
Magnetic Resonance Imaging Findings of Pituitary Hyperplasia Due to Primary Hypothyroidism
张伟宏 1朱惠娟 2张学威 1连小兰 2戴为信 2冯逢 1邢小平 2金征宇1
作者信息
- 1. 中国医学科学院北京协和医学院北京协和医院放射科,北京100730
- 2. 中国医学科学院北京协和医学院北京协和医院内分泌科,北京100730
- 折叠
摘要
Abstract
Objective To explore the clinical and magnetic resonance imaging ( MRI) findings of pituitary hyperplasia due to primary hypothyroidism. Method The clinical presentations, laboratory examinations , and MRI findings of 11 patients with pituitary hyperplasia secondary to primary hypothyroidism diagnosed at our hospitals from the beginning of 2008 to the end of 2011 were retrospectively reviewed. Results The clinical manifestationa in 11 patients included growth arrest ( 7/8 ) , mental retardation ( 6/8 ) , cold intolerance and fatigue (6/11) , slightly increased body weight (6/11) , galactorrhea (3/11) , paramenia (8/9) , precocious puberty companying vaginal bleeding (2/2) , and blurry vision (3/11). Laboratory investigations revealed grossly increased thyroid stimulating hormone, decreased thyroxine, and slightly elevated prolactin levels in all cases. Thyroid antibody was positive in six cases. On MRI, pituitary mass were detected a large intra-sellar with/without suprasellar extension in all patients, showing the characteristic of symmetric enlargement.Spherical shape was viewed in 5 cases, with the height of (12. 22 ±3. 12) mm. In the other 6 cases, the pituitary mass with the shape of calabash extended superiorly to suprasellar area, with a height of ( 18. 95 ± 2. 23) mm. The signal of pituitary mass was isointense to grey matter both on Tl weighted imaging and T2 weighted imaging. Bright short Tl signal in posterior lobe of pituitary was visible. Pituitary stalk was detected only in 4 cases from MRI without dislocation, while the width of pituitary stalk was within the normal limit. Conclusions Pituitary hyperplasia should be considered when homogenous enlargement of the pituitary gland is found on MRI. The integration of MRI findings, clinical manifestations, and laboratory findings is helpful for the proper identification of the primary endocrine disease and thus avoid misdiagnosis.关键词
甲状腺功能减退症/垂体增生/磁共振成像Key words
hypothyroidism/pituitary hyperplasia/magnetic resonance imaging分类
医药卫生引用本文复制引用
张伟宏,朱惠娟,张学威,连小兰,戴为信,冯逢,邢小平,金征宇..原发性甲状腺功能减退症伴垂体增生患者的磁共振成像表现[J].中国医学科学院学报,2012,34(5):468-473,6.
