Purpose or Case Report: Objectives:

Causes of both hypo- and hyper-secretion of pituitary hormones are important developmental pediatric pathologies for which imaging is critical for diagnostic evaluation. While various etiologies cause disruption of the hypothalamic-pituitary axis, brain magnetic resonance imaging (MRI) with dedicated pituitary gland sequences are critical to the diagnosis of structural etiologies. Congenital anomalies such as ectopic posterior pituitary which is related to short statue warrants assessment for associated midline anomalies such as optic nerve hypoplasia and corpus callosal dysgenesis. Masses yielding common symtomatic causes of pituitary dysfunction such as growth hormone deficiency secondary to rathke cleft cysts or pitutary adenomas necessitate surgical evaluation. We aim to comprehensively review overall causes related to these pathologies and relevant imaging findings which are fundamental to guide further management.

Learning Points:
This educational exhibit will discuss:
1. Embryology and development of the pituitary gland
2. Pathophysiologic review of the hypothalamic-pituitary-adrenal axis
3. Imaging protocols for evaluation of central structural causes
4. Sella/pituitary normal variants
5. Overview of positive findings on brain/pituitary magnetic resonance imaging (MRI) and case examples related to pituitary hormone hyper-secretion, such as central precocious puberty
6. Overview of positive findings on brain/pituitary MRI and case examples related to hypopituitarism, such as growth hormone deficiency

Discussion/Take-Home Points:

Proper identification of various structural causes of pituitary dysfunction on brain MRI is critical to further diagnostic, medical, or surgical management in the pediatric population.
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