Incidental Findings on Brain Magnetic Resonance Imaging (MRI) in Pediatric Endocrine Patients.

Autor:	Brener A; From the Pediatric Endocrinology and Diabetes Unit, Tel-Aviv, Israel. Electronic address: avivitb@tlvmc.gov.il., Kozyrev DA; the Department of Pediatric Neurosurgery, Tel-Aviv, Israel., Shiran SI; the Pediatric Radiology Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel., Azoulay E; From the Pediatric Endocrinology and Diabetes Unit, Tel-Aviv, Israel., Pratt LT; the Pediatric Radiology Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel., Precel R; the Pediatric Radiology Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel., Ben-Sira L; the Pediatric Radiology Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel., Eyal O; From the Pediatric Endocrinology and Diabetes Unit, Tel-Aviv, Israel., Constantini S; the Department of Pediatric Neurosurgery, Tel-Aviv, Israel., Roth J; the Department of Pediatric Neurosurgery, Tel-Aviv, Israel., Lebenthal Y; From the Pediatric Endocrinology and Diabetes Unit, Tel-Aviv, Israel.
Jazyk:	angličtina
Zdroj:	Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists [Endocr Pract] 2020 Oct; Vol. 26 (10), pp. 1105-1114.
DOI:	10.4158/EP-2020-0208
Abstrakt:	Objective: To explore incidental findings on brain magnetic resonance imaging (MRI) studies of pediatric patients referred due to endocrine disorders. Methods: A retrospective, observational study conducted in a tertiary referral center. The neuroimaging database of 17,445 brain MRI studies of 11,011 pediatric patients were searched for cases with endocrine referrals and without medical history of malignancy, genetic syndromes, and/or neurologic comorbidities. This database was linked to the pediatric neurosurgical database. Clinical data were retrieved from medical files. Results: In total, 524 patients (50.2% males, mean age 8.5±3.5 years) were referred to brain MRI due to growth disturbances (n = 313), pubertal disorders (n = 183), prolactin hypersecretion (n = 18), central diabetes insipidus (n = 8), and obesity (n = 1). Incidental findings were found in 128 (24.4%) cases. Chiari type 1 malformation was more prevalent in patients with growth disturbances (P<.001). Small pituitary cysts were observed in 20 (3.8%) patients, and pineal cysts in 25 (4.8%) patients, mostly girls (68%, P<.001). White matter lesions were diagnosed in 30 (5.7%) patients, none with clinical evidence of neurologic disease. Brain asymmetry without clinical significance and developmental venous anomalies were observed in 14 (2.7%) and 8 (1.5%) patients, respectively. Twelve patients were diagnosed with intracranial tumors, and 5 required surgical intervention for a histopathologic diagnosis of juvenile pilocytic astrocytoma (n = 3), choroid plexus papilloma (n = 1), or inconclusive (n = 1). The rest were managed conservatively. Conclusion: Incidental findings on brain MRIs of pediatric patients referred by endocrinologists are common and raise dilemmas. The spectrum ranges from structural disruptions to tumors. Decision-making is individualized and patient-centered. (© 2020 American Association of Clinical Endocrinologists. Published by Elsevier, Inc. All rights reserved.)
Databáze:	MEDLINE
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