Amenorrhea MRI
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
MRI
- Brain MRI may be helpful in the diagnosis of delayed puberty. Findings on MRI suggestive of delayed puberty include:[1]
- Hypothalamo-pituitary lesions
- Aplasia of olfactory bulb and/or sulci (Kallmann syndrome)
- Optic nerve compression (pituitary adenoma)
- Inner ear abnormalities (CHARGE syndrome)
- Brain MRI is indicated in patients with delayed puberty, experiencing some alarm signs, such as headache, visual impairment, and behavioral changes.
- Showing the aplasia of olfactory bulbs and/or sulci in MRI, it is assumed as differentiation of Kallmann syndrome from isolated hypogonadotropic hypogonadism, in patient without smelling problems or hard to evaluate.[2]
- A moderate agreement is seen between the smell identification test (UPSIT) and presence of the olfactory bulbs in MRI, in patients with hypogonadotropic hypogonadism. While, there is a good agreement between them in absence of the olfactory bulbs in MRI and anosmia.[3][2]
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Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard[4]
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Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard[4]
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Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard[4]
References
- ↑ Boehm U, Bouloux PM, Dattani MT, de Roux N, Dodé C, Dunkel L, Dwyer AA, Giacobini P, Hardelin JP, Juul A, Maghnie M, Pitteloud N, Prevot V, Raivio T, Tena-Sempere M, Quinton R, Young J (2015). "Expert consensus document: European Consensus Statement on congenital hypogonadotropic hypogonadism--pathogenesis, diagnosis and treatment". Nat Rev Endocrinol. 11 (9): 547–64. doi:10.1038/nrendo.2015.112. PMID 26194704.
- ↑ 2.0 2.1 Palmert, Mark R.; Dunkel, Leo (2012). "Delayed Puberty". New England Journal of Medicine. 366 (5): 443–453. doi:10.1056/NEJMcp1109290. ISSN 0028-4793.
- ↑ Doty RL, Shaman P, Kimmelman CP, Dann MS (1984). "University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic". Laryngoscope. 94 (2 Pt 1): 176–8. PMID 6694486.
- ↑ 4.0 4.1 4.2 Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16890">rID: 16890