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Transfusional Hemochromatosis: Quantitative Relation of MR Imaging Pituitary Signal Intensity Reduction to Hypogonadotropic Hypogonadism¹

¹ From the Institute of Radiology, Università di Palermo, Italy (G.S., A.B., R.L.); the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (A.I.); and the Department of Pediatrics, Thalassemia Service, Ospedale "Villa Sofia," Palermo, Italy (P.D.). Received June 21, 1999; revision requested August 11; revision received September 29; accepted October 20. Address correspondence to G.S., Viale Strasburgo, 167, 90146 Palermo, Italy (e-mail: sparacia@unipa.it).

PURPOSE: To assess the relationship between magnetic resonance (MR) imaging pituitary signal intensity reduction in patients with transfusional hemochromatosis and the clinical manifestation of hypogonadotropic hypogonadism.

MATERIALS AND METHODS: Pituitary MR imaging at 0.5 T was performed in 38 consecutive patients affected by secondary hemochromatosis and in 20 healthy volunteers. Serum ferritin levels were estimated in the affected population. Twenty (53%) of the 38 patients had hypogonadotropic hypogonadism diagnosed. Pituitary-to-fat signal intensity ratios were calculated from coronal gradient-echo (GRE) T2*-weighted MR images. The relationship between the quantitative reduction of the pituitary-to-fat signal intensity ratio and the clinical manifestation of pituitary dysfunction was assessed in the affected population. Signal intensity reduction in the anterior lobe of the pituitary gland was also correlated with the serum ferritin level.

RESULTS: The degree of reduction of the pituitary-to-fat signal intensity ratio correlated with the presence of hypogonadotropic hypogonadism, with a sensitivity of 90%, a specificity of 89%, and an overall accuracy of 89%. In addition, the reduction of pituitary signal intensity was greater in patients with higher ferritin levels (r = -0.55, r² = -0.30, P < .001).

CONCLUSION: The degree of signal intensity reduction, measured as the pituitary-to-fat signal intensity ratio for GRE T2*-weighted images, in patients with secondary hemochromatosis correlates with the severity of pituitary dysfunction.

Index terms: Anemia, 145.652 • Hemochromatosis, 145.519 • Hormones • Pituitary, diseases, 145.519 • Pituitary, MR, 145.121412

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