Is contrast MRI needed in pediatric patients with growth hormone deficiency?

A recent study found that in patients with growth hormone deficiency, central precocious puberty, and short stature, most relevant radiologic findings were detectable with noncontrast MRI. As a result, the study authors suggested a “rapid noncontrast pituitary” MRI protocol for these patients, resulting in a decrease in contrast and anesthesia use.

Pituitary MR imaging studies (n = 134) of patients between the ages of 0-18 years with growth hormone deficiency, central precocious puberty, or short stature were blinded and reviewed by 2 subspecialty-trained pediatric neuroradiologists.

A blinded review of noncontrast images had 70% concordance with the original report. More than half of the discrepancies (22 out of 40) were considered unrelated to the indication. Contrast was only needed for 9 cases for further characterization.

Reference
Huang J, Sarma A, Gupta N, et al. Noncontrast MRI Protocol for Selected Pediatric Pituitary Endocrinopathies: A Procedure with High Diagnostic Yield and Potential to Reduce Anesthesia and Gadolinium-Based Contrast Exposure. AJNR Am J Neuroradiol. 2021 Sep 2. doi: 10.3174/ajnr.A7228. Epub ahead of print. PMID: 34475192.