A Descriptive Study to Find Possible Correlation between Pituitary Magnetic Resonance Image Findings and Abnormal Pituitary Hormones: A Retrospective Single Centre Study in Saudi Community Based Hospital

Background: Data on pituitary Magnetic Resonance Imaging (MRI) in patients with abnormal pituitary hormones in Saudi Arabia are very scarce.

Objective: To define the frequency of normal pituitary MRI in patients with abnormal pituitary hormones in a well-defined population.

Design: Retrospective analysis of radiological and hormonal data of patients with pituitary MRI between January 2008 and December 2015.

Settings: Departments of Endocrinology and Radiology at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.

Patients: 459 patients with clinical, hormonal and radiological data.

Main outcome measures: The frequency of normal pituitary MRI in patients with abnormal pituitary hormones.

Results: Over the 7-year period, Out of 459 patients; 129 (28.1 %) were males and 330 (71.9 %) were females with mean age of 35.4 ± 13.7. Positive MRI compared to normal MRI were seen in 268 (58.4 %) and 191 (41.6 %) subjects respectively. Subjects with Positive MRI were significantly older, 36.8 ± 14.1 vs. 33.5 ± 12.9, p value=0.01. Hyperfunctiong pituitary hormones were significantly associated with positive MRI, 259 (63.2%) vs. 151 (36.8) where as hypofunctiong pituitary hormones were associate with normal MRI, 40 (81.6%) vs. 9 (18.4%), p value < 0.001. Females with hyperfunctioning pituitary hormones were significantly associated with positive MRI whereas males with hyporfunctioning pituitary hormones were significantly associated with normal MRI. Three types of hyperfunctioning pituitary gland were seen such as hyperprolactinemia, somatotroph adenoma, and corticotroph adenoma were associated with more frequent positive MRI as to Five types of hypofunctioning pituitary gland were seen such as panhypopituitarism, secondary hypogonadism, growth hormone deficiency, central hypothyroidism and central adrenal insufficiency which were associated with more frequent normal MRI.

Conclusion: The current study indicates hyperfunctioning pituitary gland was significantly associated with positive MR whereas hypofunctioning pituitary gland was associate with normal MRI. In the absence of registry data, larger cooperative studies involving diverse population samples from multiple centers could help to provide further information on the true frequency nationally.

Limitations: Question of clustering of cases within the study region and limited study sample size.