title: Pituitary iron and volume imaging in healthy controls.
abstract: OBJECTIVE
  Patients with transfusional iron overload develop iron deposits in the pituitary gland, which are associated with volume loss and HH. The purpose of this study was to characterize R2 and volumetric data in a healthy population for diagnostic use in patients with transfusional iron overload.
  
  
  METHODS
  One hundred healthy controls without iron overload between the ages of 2 and 48 were recruited to have MR imaging of the brain to assess their pituitary R2 and volume. Pituitary R2 was assessed with a 8-echo spin-echo sequence, and pituitary volumes, by a 3D spoiled gradient-echo sequence with 1-mm(3) resolution. A 2-component continuous piecewise linear approximation was used for creating volumetric and R2 nomograms. Equations were generated from regression relationships for convenient z-score calculation.
  
  
  RESULTS
  Pituitary R2 rose weakly with age (r(2) = 0.19, P < .0001). Anterior and total pituitary volumes increased steadily up to 18 years of age, after which volume slightly decreased. Females had larger pituitary glands, most likely representing their larger lactotroph population.
  
  
  CONCLUSIONS
  From these data, a clinician can calculate the z scores for R2 and pituitary volume in patients with iron overload. Normal ranges are well-differentiated from values previously associated with endocrine disease in transfusional siderosis; this finding suggests that preclinical iron overload can be recognized and appropriately treated.
authors.affiliation: Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California 90027, USA.
authors.forename: L J
authors.initials: LJ
authors.lastname: Noetzli
authors.forename: A
authors.initials: A
authors.lastname: Panigrahy
authors.forename: A
authors.initials: A
authors.lastname: Hyderi
authors.forename: A
authors.initials: A
authors.lastname: Dongelyan
authors.forename: T D
authors.initials: TD
authors.lastname: Coates
authors.forename: J C
authors.initials: JC
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007501:Iron / Q000032:analysis / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010902:Pituitary Gland / Q000033:anatomy & histology* / Q000737:chemistry / Q000378:metabolism*; D012016:Reference Values; D055815:Young Adult
chemical_list: D007501:Iron
references.citation: Eur J Radiol. 2007 Apr;62(1):138-42
references.pmid: 17161570
references.citation: Blood. 2009 Nov 5;114(19):4021-6
references.pmid: 19726718
references.citation: Neuroimage. 2003 Sep;20(1):22-33
references.pmid: 14527567
references.citation: Clin Anat. 2007 Nov;20(8):933-42
references.pmid: 17879305
references.citation: Horm Res. 2002;58 Suppl 1:72-9
references.pmid: 12373018
references.citation: Neuroimage. 2011 Jan 15;54(2):750-9
references.pmid: 20923707
references.citation: Neuroradiology. 2001 Dec;43(12):1056-8
references.pmid: 11792043
references.citation: Mol Pharmacol. 1997 Apr;51(4):535-41
references.pmid: 9106616
references.citation: Pediatr Endocrinol Rev. 2007 Jun;4(4):335-42
references.pmid: 17643081
references.citation: J Clin Endocrinol Metab. 2005 Jun;90(6):3274-8
references.pmid: 15784716
references.citation: Ann N Y Acad Sci. 2010 Aug;1202:123-8
references.pmid: 20712782
references.citation: AJR Am J Roentgenol. 2000 Dec;175(6):1567-9
references.pmid: 11090376
references.citation: Gynecol Endocrinol. 2010 Apr;26(4):307-10
references.pmid: 20021296
references.citation: Acta Radiol. 2010 Feb;51(1):71-7
references.pmid: 20001472
references.citation: Br J Haematol. 2009 Sep;146(5):546-56
references.pmid: 19604241
references.citation: J Magn Reson Imaging. 2006 Jan;23(1):9-16
references.pmid: 16329085
references.citation: Pediatr Radiol. 2004 Jul;34(7):547-51
references.pmid: 15114413
references.citation: J Pediatr Hematol Oncol. 2010 May;32(4):259-66
references.pmid: 20445415
references.citation: Haematologica. 2004 Oct;89(10):1187-93
references.pmid: 15477202
references.citation: N Engl J Med. 2000 Aug 3;343(5):327-31
references.pmid: 10922422
references.citation: J Magn Reson Imaging. 2008 Jul;28(1):29-33
references.pmid: 18581349
references.citation: AJNR Am J Neuroradiol. 1999 Feb;20(2):312-5
references.pmid: 10094362
references.citation: J Urol. 2008 Jun;179(6):2327-32
references.pmid: 18423706
references.citation: Br J Haematol. 2010 Feb;148(3):466-75
references.pmid: 19912219
references.citation: Eur Radiol. 2007 Dec;17(12):3025-30
references.pmid: 17549485
references.citation: Blood. 2005 Aug 15;106(4):1460-5
references.pmid: 15860670
references.citation: J Pediatr Endocrinol Metab. 2000 Feb;13(2):179-84
references.pmid: 10711663
references.citation: Arch Neurol. 2003 Jul;60(7):989-94
references.pmid: 12873856
references.citation: Ann N Y Acad Sci. 1998 Jun 30;850:191-201
references.pmid: 9668540