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Pituitary Magnetic Resonance Imaging in Patients with Isolated Hypogonadotrophic Hypogonadism: A Single Center Experience

Dilek Arpaci, Neslihan Cuhaci, Didem Ozdemir, Mina Gulfem Kaya, Mehmet Gumus, Reyhan Ersoy, Bekir Cakir.




Abstract

Hypogonadism is a result of testicular/ovarian failure and/or insufficient pituitary stimulation. Various hypothalamo-pituitary abnormalities or lesions can contribute to hypogonadism. Benign or malign tumoural lesions of cellar or paracellar region, may lead to hypogonadism. Therefore, pituitary magnetic resonance imaging (MRI) is needed in patients with hypogonadism. In our study, we aimed to investigate our hypothalamo-pituitary MRI findings of hypogonadal patients. We evaluated 42 isolated hypogonadal patients followed in our clinic. These patients’ pituitary MRI findings were analyzed retrospectively. 80.9 % of isolated hypogonadotrophic patients’ were male, 19.1 % were female. Pituitary MRI findings of isolated hypogonadotrophic patients revealed that; 59.5% (n=25) were normal, 16.7 % (n=7) pituitary microadenoma, 11.9% (n=5) partial empty sella, 4.7% (n=2) pituitary macroadenoma, 2.4% empty sella (n=1), 2.4% (n=1) ectopic neuropituitary, and 2.4% (n=1) empty sella plus ectopic neuropituitary together. In half of the patients with isolated hypogonadotrophic hypogonadism, pituitary MRI findings may be normal. In these patients, if clinic and laboratory results are harmonious, to determine the diagnosis dynamic tests are required and appropriate therapy must be done, even if pituitary MRI is normal.

Key words: Hypogonadism, magnetic resonance imaging, microadenoma, macroadenoma






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