Study On MRI Features And Related Hormones Of Pituitary Hyperplasia Caused By Primary Hypothyroidism

Objective: To analyze the MRI features and the relationship between pituitary hyperplasia and hormone levels of each target gland axis in patients with pituitary hyperplasia caused by primary hypothyroidism,in order to provide imaging evidence for diagnosis and treatment of patients with pituitary hyperplasia caused by primary hypothyroidism.Methods:A retrospective collection of all patients with primary hypothyroidism and pituitary MRI examinations at the General Hospital of Ningxia from August 2015 to January 2020 was selected in strict accordance with the inclusion and exclusion criteria.A total of 54 patients were eventually included in the case group.They were divided into pituitary hyperplasia caused by hypothyroidism:(group A)21 cases,non-hypophysis:(group B)33 cases according to MRI features,the patients who underwent pituitary MRI at the same time and had normal clinical endocrine-related examinations were selected as the control group:(group C)a total of 46 cases.The clinical data(gender,age,clinical manifestations,etiology)of patients in groups A and B were collected and analyzed;laboratory hormone levels were collected from all subjects,the pituitary height(sagittal,coronal)?length and breadth were measured by using the GEADW4.2 workstation,the relationship between the hormone levels of each target gland and the pituitary axis of MRI in the three groups was analyzed,the MRI features of the pituitary hyperplasia group caused by primary hypothyroidism were summarizd.Results:1?Clinical data: Thyroiditis is the main cause of disease in the case group;clinical manifestations are mostly afraid of cold,fatigue,and anorexia;There were more women in the case group than in the control group,and the difference between the two groups was statistically significant(p<0.05).2?The differences in TSH?FT3,FT4,PRL,and FSH between the three groups were statistically significant(P <0.05);There were no significant differences in ACTH,COR(8AM),COR(4PM),LH,and TSTO between the three groups(P> 0.05).3?The differences in pituitary height(sagittal,coronal),length and breadth among the three groups were statistically significant(p <0.05).4?Pituitary hyperplasia group: Pituitary height(sagittal,coronal)was positively correlated with TSH and PRL,TSH was inversely correlated with FT3 and FT4,and TSH was positively correlated with PRL.5?MRI featuers of pituitary hyperplasia caused by primary hypothyroidism: In hyperplasia group,the signal of hypophysis hyperplasia was uniform,presented as iso-signal on T1 and T2.,on the early enhanced scan the pituitary showed significantly and uniformly enhanced,and no cystic degeneration,hemorrhage and necrosis.17 patients were centered with pituitary stalk,1was left-biased,and 3 were right-biased;three were visually compressed,21 cases of bilateral cavernous sinus were not affected.Conclusion:1?Pituitary hyperplasia has characteristic MRI features,providing imaging basis for diagnosis and treatment of hypothyroidism.2?Primary hypothyroidism can lead to pituitary hyperplasia and cause changes in gonadal axis hormone levels.3?Hormone levels and pituitary size can reflect the severity of hypothyroidism.4?Hypothyroidism disease is more serious,more likely to lead to pituitary hyperplasia.