title: Utility of magnetic resonance imaging in the evaluation of the child with central diabetes insipidus.
abstract: Because of the association of central diabetes insipidus (CDI) and occult neoplasia, magnetic resonance imaging (MRI) is an important component of the diagnostic evaluation of a child with CDI. In more than 90% of these children, MRI (T1 weighted-image, without contrast) demonstrates an absence of the normal hyperintensity of the posterior pituitary. In one third of patients, the pituitary stalk is also thickened, suggesting infiltrative disease. Of those with a thickened stalk, the etiology of the CDI remains undetermined in about 60% of patients, whereas histiocytosis and occult germinoma each account for approximately 15-20% of patients. In contrast, germinoma is infrequent (3%) in children with CDI and an MRI showing a normal infundibular stalk, though histiocytosis still accounts for 15-20% of patients. In this paper, a diagnostic approach in children with CDI is proposed.
authors.affiliation: Department of Pediatrics and Radiology, The Children's Hospital of Philadelphia, and University of Pennsylvania School of Medicine, 19104, USA. alterc@email.chop.edu
authors.forename: Craig A
authors.initials: CA
authors.lastname: Alter
authors.forename: Larissa T
authors.initials: LT
authors.lastname: Bilaniuk
mesh_terms: D000293:Adolescent; D003919:Diabetes Insipidus / Q000175:diagnosis* / Q000473:pathology; D018237:Germinoma / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010902:Pituitary Gland / Q000473:pathology; D010903:Pituitary Gland, Anterior / Q000473:pathology; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000473:pathology; D012016:Reference Values