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© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

The aim of this study was to assess the diagnostic value of non-contrast pituitary MRI in children with growth or puberty disorders (GPDs) and to determine the criteria indicating the necessity to perform post-contrast examination. A retrospective study included re-analysis of 567 contrast-enhanced pituitary MRIs of children treated in a tertiary reference center. Two sets of sequences were created from each MRI examination: Set 1, including common sequences without contrast administration, and Set 2, which included common pre- and post-contrast sequences (conventional MRI examination). The differences in the visibility of pituitary lesions between pairs of sets were statistically analyzed. The overall frequency of Rathke’s cleft cysts was 11.6%, ectopic posterior pituitary 3.5%, and microadenomas 0.9%. Lesions visible without contrast administration accounted for 85% of cases. Lesions not visible before and diagnosed only after contrast injection accounted for only 0.18% of all patients. Statistical analysis showed the advantage of the antero-posterior (AP) pituitary dimension over the other criteria in determining the appropriateness of using contrast in pituitary MRIs. The AP dimension was the most significant factor in logistic regression analysis: OR = 2.23, 95% CI, 1.35–3.71, p-value = 0.002, and in ROC analysis: AUC: 72.9% with a cut-off value of 7.5 mm, with sensitivity/specificity rates of 69.2%/73.5%. In most cases, the use of gadolinium-based contrast agent (GBCA) in pituitary MRI in children with GPD is unnecessary. The advantages of GBCA omission include shortening the time of MRI examination and of general anesthesia; saving time for other examinations, thus increasing the availability of MRI for waiting children; and acceleration in their further clinical management.

Details

Title
MRI Protocol for Pituitary Assessment in Children with Growth or Puberty Disorders—Is Gadolinium Contrast Administration Actually Needed?
Author
Michali-Stolarska, Marta 1 ; Tukiendorf, Andrzej 2   VIAFID ORCID Logo  ; Zacharzewska-Gondek, Anna 1   VIAFID ORCID Logo  ; Jacków-Nowicka, Jagoda 1 ; Chrzanowska, Joanna 3 ; Trybek, Grzegorz 4   VIAFID ORCID Logo  ; Bladowska, Joanna 1   VIAFID ORCID Logo 

 Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, 50-367 Wroclaw, Poland; [email protected] (M.M.-S.); [email protected] (J.J.-N.); [email protected] (J.B.) 
 Department of Public Health, Wroclaw Medical University, 50-367 Wroclaw, Poland; [email protected] 
 Department of Developmental Endocrinology and Diabetology, Wroclaw Medical University, 50-367 Wroclaw, Poland; [email protected] 
 Department of Oral Surgery, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland; [email protected] 
First page
4598
Publication year
2021
Publication date
2021
Publisher
MDPI AG
e-ISSN
20770383
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2581003577
Copyright
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.