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C-1695 - MR features of each subtype of Primary Autoimmune Hypophysitis 

T. Tartaglione1, S. chiloiro2, M. Laino1, S. Gaudino3, R. russo1, C. Colosimo1; 1 Rome/IT 2 rome/IT 3 ROME/IT Type: Scientific Exhibit
Area of Interests: Neuroradiology brain, Head and neck
Imaging Technique: MR
Procedure: Education
Special Focuses: Endocrine disorders, Inflammation
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Aims and objectives: Primary autoimmune hypophysitis (PAH) is a rare neuroendocrine disease in which there is an inflammatory infiltration of the pituitary gland (1). The pathogenesis is not well known, but an autoimmune etiology has been suggested (2, 3). According to the affected area, PAH can be classified in adeno-h[...]

Methods and materials: A monocentric retrospective study was conducted on PAH affected patients, evaluated from 2011. After ruling out the presence of other pituitary mass and secondary causes of hypophysitis, PAH was the exclusion diagnosis. MR examinations were performed using a 1,5 T MR scanner (Optima HDxt, General El[...]

Results: 21 Patients met the inclusion criteria. All cases were clinically and laboratoristic diagnosed for anterior hypopituitarism and/or insipidus diabetes. In 9 cases with AH, adenohypophysis was swollen and showed non-homogeneous contrast enhancement (Fig. 1). In patients with INH, the loss of the neuro[...]

Conclusion: Even if the gold standard in the diagnosis of PAH remains pituitary biopsy, MR represents the best imaging tool for a minimally invasive diagnosis and, when integrated with clinical and laboratory findings, can help to avoid unnecessary surgery.

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References:    Akahori H, Sugimoto T. Lymphocytic hypophysitis with a long latent period from onset of central diabetes insipidus to development of pituitary enlargement. Intern Med. 2010;49(15):1565-71. Epub 2010 Aug[...]

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