Neuroimaging Review of Pediatric Endocrinopathies

The hypothalamic-pituitary axis regulates many important functions in a child, including growth, puberty, and maintenance of physiologic homeostasis. Dysfunction of the hypothalamic-pituitary axis can produce hormone disturbances that result in various pediatric neuroendocrinopathies, including an isolated growth hormone deficiency, multiple pituitary hormone deficiencies, precocious or delayed puberty, central diabetes insipidus, and elevated pituitary hormone conditions (eg, hyperprolactinemia). Although the hormonal abnormalities in a child with endocrinopathy are typically well characterized with clinical and laboratory evaluations by an endocrinologist, neuroimaging with brain MR imaging can be critical for identifying an underlying etiology to guide prognosis and treatment. Neuroendocrinopathies can be congenital, such as from genetic mutations involved in hypothalamic-pituitary axis development, or acquired, such as with pediatric suprasellar masses, trauma, or inflammatory conditions, or after cranial irradiation. This article reviews the clinical presentations, pathophysiologies, etiologies, and MR imaging findings in children who present with specific types of neuroendocrinopathies.

Learning Objective: To review the pathophysiologies, etiologies, and associated neuroimaging findings in the most commonly imaged pediatric neuroendocrinopathies.