Amenorrhea MRI: Difference between revisions
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==MRI== | ==MRI== | ||
MRI is | * [[Brain]] [[MRI]] may be helpful in the diagnosis of delayed [[puberty]]. Findings on [[MRI]] suggestive of delayed [[puberty]] include:<ref name="pmid26194704">{{cite journal |vauthors=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 |title=Expert consensus document: European Consensus Statement on congenital hypogonadotropic hypogonadism--pathogenesis, diagnosis and treatment |journal=Nat Rev Endocrinol |volume=11 |issue=9 |pages=547–64 |year=2015 |pmid=26194704 |doi=10.1038/nrendo.2015.112 |url=}}</ref> | ||
** [[Hypothalamus|Hypothalamo]]-[[pituitary]] lesions | |||
** [[Aplasia]] of [[olfactory bulb]] and/or [[Sulci (anatomy)|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 (anatomy)|sulci]] in [[MRI]], it is assumed as differentiation of [[Kallmann syndrome]] from isolated [[hypogonadotropic hypogonadism]], in patient without smelling problems or hard to evaluate.<ref name="PalmertDunkel2012">{{cite journal|last1=Palmert|first1=Mark R.|last2=Dunkel|first2=Leo|title=Delayed Puberty|journal=New England Journal of Medicine|volume=366|issue=5|year=2012|pages=443–453|issn=0028-4793|doi=10.1056/NEJMcp1109290}}</ref> | |||
* 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]].<ref name="pmid6694486">{{cite journal |vauthors=Doty RL, Shaman P, Kimmelman CP, Dann MS |title=University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic |journal=Laryngoscope |volume=94 |issue=2 Pt 1 |pages=176–8 |year=1984 |pmid=6694486 |doi= |url=}}</ref><ref name="PalmertDunkel2012" /> | |||
<gallery align="left"> | |||
image:Pituitary-adenoma-1.jpg|thumb|300px|Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16890">rID: 16890</ref> | |||
image:Hypothalamic-hamartoma.jpeg|thumb|300px|Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16890">rID: 16890</ref> | |||
image:Pituitary-macroadenoma-non-functioning-null-cell (1).jpg|thumb|300px|Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/5562">rID: 5562</ref> | |||
</gallery> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 18:37, 2 October 2017
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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]
-
![Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard[4]](/images/1/12/Pituitary-adenoma-1.jpg)
Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard[4]
-
![Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard[4]](/images/6/66/Hypothalamic-hamartoma.jpeg)
Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard[4]
-
![Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard[4]](/images/a/a2/Pituitary-macroadenoma-non-functioning-null-cell_%281%29.jpg)
Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard[4]
![Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard[4]](/index.php/File:Pituitary-adenoma-1.jpg)
![Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard[4]](/index.php/File:Hypothalamic-hamartoma.jpeg)
![Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard[4]](/index.php/File:Pituitary-macroadenoma-non-functioning-null-cell_(1).jpg)
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