title: Usefulness of magnetic resonance findings of the hypothalamic-pituitary region in the management of short children with growth hormone deficiency: evidence from a longitudinal study.
abstract: OBJECTIVE
  The purpose of this study is to assess the relationship between magnetic resonance images (MRI) of the hypothalamic-pituitary (H-P) region and response to recombinant human growth hormone (rhGH) treatment in short children with growth hormone deficiency, basing on changes of auxologic parameters, as well as to answer the question if MRI may serve for selecting and monitoring the rhGH responders.
  
  
  METHODS
  The study group comprised 85 children treated with rhGH, aged 7.3-18.7 years, followed for the mean period of 3.2 years (range, 2.1-9.5 years). Auxologic parameters (height deficit hSDS, deviation from the mid-parental height hSDS-mpSDS, bone delay index bone age/chronological age ratio (BA/CA)) were assessed before, during and at the end of rhGH treatment; growth velocity was calculated before and during rhGH therapy. Parameters were correlated with the MRI of the H-P region.
  
  
  RESULTS
  Structural anomalies of the H-P region were found in 22 (25.9%) children: empty sella syndrome (ESS) in 12 (14.1%) patients, ectopic posterior pituitary (EPP) in ten (11.8%). Patients' height deficit and their deviation from parental height before rhGH therapy was significantly greater in the EPP group (median hSDS = -3.8; hSDS-mpSDS = -2.5), bone age delay was the greatest in the ESS group (median BA/CA = 0.69), after therapy - in the EPP group (median BA/CA = 0.82). Growth velocity improved in the first year of the rhGH therapy in all groups; however, the most significant acceleration was observed in the EPP group (median delta hSDS = 0.9), then stabilised and was comparable in all groups.
  
  
  CONCLUSIONS
  MRI may be helpful in predicting response to the rhGH treatment, providing midline abnormalities are taken into account.
authors.affiliation: Department of Paediatrics, Paediatric Endocrinology and Diabetes, Medical University of Silesia, Upper Silesia Centre for Child's Health ul. Medyków 16, 40-752 Katowice, Poland. majak_2001@yahoo.com
authors.forename: Maria A
authors.initials: MA
authors.lastname: Kalina
authors.forename: Barbara
authors.initials: B
authors.lastname: Kalina-Faska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Gruszczyńska
authors.forename: Jan
authors.initials: J
authors.lastname: Baron
authors.forename: Ewa
authors.initials: E
authors.lastname: Małecka-Tendera
mesh_terms: D000293:Adolescent; D001827:Body Height; D002648:Child; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use; D006801:Humans; D007031:Hypothalamus / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010902:Pituitary Gland / Q000473:pathology*; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D011994:Recombinant Proteins; D019382:Human Growth Hormone