MRI imaging features of the pituitary gland in children with central precocious puberty and their correlation with bone age
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摘要:
目的 探讨儿童中枢性性早熟（CPP）垂体MRI影像学特征及其与骨龄的相关性。 方法 选取2019年11月~2021年11月于我院收治的CPP患儿96例作为研究组，另选取同期健康体检儿童90例作为对照组。比较两组MRI影像学表现和骨龄X线表现，并对CPP患儿MRI影像学特征与骨龄X线相关性进行分析。 结果 MRI参数中，研究组冠状高径和前后径均长于对照组（P < 0.05），冠状宽径短于对照组（P < 0.05）；两组矢状高径差异比较无统计学意义（P>0.05）。研究组患儿垂体上缘呈“平坦形”所占比例低于对照组（P < 0.05），“隆起形”所占比例高于对照组（P < 0.05）；两组垂体上缘呈“凹陷形”所占比例差异无统计学意义（P>0.05）。研究组患儿骨龄X线结果显示“骨龄正常”所占比例低于对照组（P < 0.05），“骨龄提前”所占比例高于对照组（P < 0.05）；两组“骨龄延迟”所占比例差异比较无统计学意义（P>0.05）。研究组患儿垂体的冠状高径、冠状宽径、矢状高径、前后径均与骨龄提前呈负相关（r=-0.216、-0.345、-0.539、-0.478，P < 0.05），与骨龄延迟呈正相关（r=0.516、0.609、0.784、0.542，P < 0.05）；垂体参数与骨龄正常相比相关性较弱，其中冠状高径、矢状高径与其呈相关（r=0.490、0.241，P < 0.05），与冠状宽径及前后径均无明显相关性（均P>0.05）。 结论 排除器质性原因，CPP患儿垂体形态及高度可见明显异常，多呈“隆起形”，与骨龄提前及延迟均呈正相关，垂体影像学特征与骨龄结合可对CPP临床诊断及治疗提供指导价值。 Abstract:Objective To investigate the imaging features of pituitary MRI and its correlation with bone age in children with central precocity (CPP). Methods A total of 96 children with central precocity admitted to our hospital from November 2019 to November 2021 were selected as the research group, and another 90 children with healthy physical examination during the same period were selected as the control group. The MRI imaging manifestations and bone age X- ray manifestations were compared between the two groups, and the correlation between MRI imaging features and bone age X-ray in children with CPP was analyzed. Results In MRI parameters, the length of coronal high diameter and anterior and posterior diameter in the study group was longer than that in the control group (P < 0.05), and the width diameter of coronal was shorter than that in the control group (P < 0.05). There was no significant difference in sagittal height between the two groups (P>0.05). The proportion of children in the research group with a "flat shape" superior pituitary margin was lower than that in the control group (P < 0.05), and the proportion of children with a "raised shape" superior pituitary margin was higher than that in the control group (P < 0.05); There was no significant difference in the proportion of "depressed shape" in the superior pituitary margin between the two groups (P>0.05). X-ray results of bone age in the study group showed that the proportion of "normal bone age" was significantly lower than that in the control group (P < 0.05), and the proportion of "advanced bone age" was higher than that in the control group (P < 0.05). There was no significant difference in the proportion of "delayed bone age" between the two groups (P>0.05). In the MRI parameters, the coronal height and anterior-posterior diameter of the study group were longer than In the study group, the coronal height diameter, coronal width diameter, sagittal height diameter and anterior and posterior diameter of the pituitary were negatively correlated with the advance of bone age (r=-0.216, -0.345, -0.539, -0.478, P < 0.05), and positively correlated with the delayed bone age (r=0.516, 0.609, 0.784, 0.542, P < 0.05); The correlation between pituitary parameters and normal bone age was weak, with coronal height diameter and sagittal height diameter correlating with it (r=0.490, 0.241, P < 0.05), and no significant correlation with coronal width diameter and anterior and posterior diameter (P>0.05). Conclusion Excluding organic causes, the pituitary morphology and height of children with CPP were found to be significantly abnormal, mostly in the shape of "bulge", and positively correlated with both early and delayed bone age. The combination of pituitary imaging features and bone age can provide guidance for the clinical diagnosis and treatment of CPP. -
Key words:
- children central precocity /
- pituitary gland /
- magnetic resonance imaging /
- imaging features /
- bone age /
- correlation
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图 1 3例患者T1+T2平扫图像及T1增强后图像
A~B、D~E、G~H: T1+T2平扫图像; C、F、I: T1增强后图像.
Figure 1. The flat scan images of T1+T2 and T1 enhanced image of 3 patients.
表 1 一般资料对比
Table 1. Comparison of general data
组别 性别（n） 年龄（岁） 男 女 最小 最大 平均（Mean±SD） 对照组（n=90） 35 55 4 10 6.99±0.71 研究组（n=96） 31 65 5 10 7.07±0.74 χ2/t 0.879 0.751 P 0.347 0.453 
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表 2 两组儿童垂体MRI相关参数对比
Table 2. Comparison of MRI related parameters of pituitary between the two groups (mm, Mean±SD)
组别 冠状高径 冠状宽径 矢状高径 前后径 对照组（n=90） 3.86±0.41 12.47±1.31 4.63±0.48 7.12±0.72 研究组（n=96） 5.04±0.52 11.39±1.20 4.67±0.47 7.92±0.81 t 17.111 5.868 0.574 7.102 P < 0.001 < 0.001 0.567 < 0.001
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表 3 两组儿童垂体上缘形态比较
Table 3. Comparison of MRI related parameters of pituitary between the two groups [n(%)]
组别 凹陷形 隆起形 平坦形 对照组（n=90） 9（10.00） 3（3.33） 78（86.67） 研究组（n=96） 17（17.71） 56（58.33） 23（23.96） χ2 2.301 64.881 73.614 P 0.130 < 0.001 < 0.001
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表 4 两组骨龄X线结果对比
Table 4. Comparison of bone age X-ray results between the two groups [n(%)]
组别 骨龄延迟 骨龄正常 骨龄提前 对照组（n=90） 6（6.67） 81（90.00） 3（3.33） 研究组（n=96） 10（10.42） 23（23.96） 63（67.74） χ2 0.831 82.193 78.734 P 0.362 < 0.001 < 0.001
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表 5 垂体参数与骨龄X线结果相关性
Table 5. The correlation between pituitary parameters and bone age X-ray results
指标 冠状高径 冠状宽径 矢状高径 前后径 骨龄提前 r=-0.216 r=-0.345 r=-0.539 r=-0.478 P=0.037 P=0.014 P=0.004 P=0.025 骨龄正常 r=0.490 r=0.176 r=0.241 r=0.189 P=0.045 P=0.066 P=0.038 P=0.276 骨龄延迟 r=0.516 r=0.609 r=0.784 r=0.542 P=0.023 P=0.010 P=0.006 P=0.018
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