title: Pituitary imaging findings in male patients with hypogonadotrophic hypogonadism.
abstract: BACKGROUND
  Data on pituitary imaging in adult male patients presenting with hypogonadotrophic hypogonadism (HH) and no known pituitary disease are scarce.
  
  
  OBJECTIVE
  To assess the usefulness of pituitary imaging in the evaluation of men presenting with HH after excluding known pituitary disorders and hyperprolactinemia.
  
  
  METHODS
  A historical prospective cohort of males with HH.
  
  
  METHODS
  Men who presented for endocrine evaluation from 2011 to 2014 with testosterone levels <10.4 nmol/L (300 ng/mL), normal LH and FSH levels and no known pituitary disease.
  
  
  RESULTS
  Seventy-five men were included in the analysis. Their mean age and BMI were 53.4 ± 14.8 years and 30.7 ± 5.2 kg/m2, respectively. Mean total testosterone, LH, and FSH were 6.2 ± 1.7 nmol/L, 3.4 ± 2 and 4.7 ± 3.1 mIU/L, respectively. Prolactin level within the normal range was obtained in all men (mean 161 ± 61, range 41-347 mIU/L). Sixty-two men had pituitary MRI and 13 performed CT. In 61 (81.3%) men pituitary imaging was normal. Microadenoma was found in 8 (10.7%), empty sella and thickened pituitary stalk in one patient (1.3%) each. In other four patients (5.3%) a small or mildly asymmetric pituitary gland was noted. No correlation was found between testosterone level and the presence of pituitary anomalies.
  
  
  CONCLUSIONS
  This study suggests that the use of routine hypothalamic-pituitary imaging in the evaluation of IHH, in the absence of clinical characteristics of other hormonal loss or sellar compression symptoms, will not increase the diagnostic yield of sellar structural abnormalities over that reported in the general population.
authors.affiliation: Endocrine Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel, daniaron@netvision.net.il.
authors.forename: Dania
authors.initials: D
authors.lastname: Hirsch
authors.forename: Carlos
authors.initials: C
authors.lastname: Benbassat
authors.forename: Yoel
authors.initials: Y
authors.lastname: Toledano
authors.forename: Irena
authors.initials: I
authors.lastname: S'chigol
authors.forename: Gloria
authors.initials: G
authors.lastname: Tsvetov
authors.forename: Ilana
authors.initials: I
authors.lastname: Shraga-Slutzky
authors.forename: Yoav
authors.initials: Y
authors.lastname: Eizenberg
authors.forename: Ilan
authors.initials: I
authors.lastname: Shimon
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004652:Empty Sella Syndrome / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007006:Hypogonadism / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000000981:diagnostic imaging / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed