Background: All children with Growth Hormone Deficiency (GHD) should have a Magnetic Resonance Imaging (MRI) scan performed as standard (GH Research Society, 2000).
Aims: To determine whether all patients diagnosed with GHD as determined by stimulation testing had an MRI scan performed; and to examine the relationship between the results of endocrine investigations and MRI scans.
Methods: Retrospective review of all children who had GH stimulation tests from 20102011 at a single tertiary institution.
Results: 85 children (45 male) were identified. The median age (range) was 9 years (1, 23 years). 51 (60%) had an Arginine Synacthen test and 44 (40%) had an Insulin Tolerance Test. Fifty-four children (64%) were diagnosed with GHD with a peak GH level <6 mcg/l of whom 43 (79%) had an MRI brain (Table). Reasons for not carrying out MRI in 7 of the remaining 11 patients were: waiting until old enough to tolerate MRI with a general anaesthetic (2); autosomal dominant GHD affecting parent (2); oncology patient post cranial irradiation therapy (1); MRI appointment pending (1). In 4 patients there was no documented reason for not having an MRI scan. Fourteen of the 31 non-GHD patients underwent MRI scanning (Table).
Conclusions: As a second-line investigation, most children with GHD do undergo an MRI scan for elucidating the underlying aetiology. Clearer diagnostic protocols are required to clarify the need for an MRI scan in suspected cases of GHD and whether this should be a first or second-line test.
Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.
MRI results according to peak GH levels