OBJECTIVE: To summarize the characteristics of
patients with
pituitary stalk thickening, analyze the
association between
pituitary stalk width and
hypopituitarism , and develop a diagnostic model to differentiate neoplastic and inflammatory origins.
A total of 325
patients with
pituitary stalk thickening in a tertiary
teaching hospital between January 2012 and February 2018 were enrolled. Basic characteristics and hormonal status were evaluated.
Indicators to predict etiology in
patients with histologic
diagnoses were analyzed.
RESULTS: Of the 325
patients , 62.5% were
female . Deficiency in
gonadotropin was most common, followed by
corticotropin ,
growth hormone , and
thyrotropin . The increase in
pituitary stalk width was associated with a
risk of
central diabetes insipidus (
odds ratio [OR], 3.57; P<.001) and with a combination of
central diabetes insipidus and anterior pituitary deficiency (OR, 2.28; P = .029). The cut-off
pituitary stalk width of 4.75 mm had a
sensitivity of 69.2% and a
specificity of 71.4% for the presence of
central diabetes insipidus together with anterior pituitary deficiency. Six
indicators (
central diabetes insipidus , pattern of
pituitary stalk thickening,
pituitary stalk width, neutrophilic
granulocyte percentage,
serum sodium level, and
gender ) were used to develop a model having an accuracy of 95.7% to differentiate neoplastic from inflammatory causes.
CONCLUSION: Pituitary stalk width could indicate the presence of anterior pituitary dysfunction, especially in
central diabetes insipidus patients . With the use of a diagnostic model, the neoplastic and inflammatory causes of
pituitary stalk thickening could be preliminarily differentiated.
Abbreviations : APD = anterior pituitary dysfunction;
AUC = area under the curve; CDI =
central diabetes insipidus ; GH =
growth hormone ; MRI =
magnetic resonance imaging ; OR = odd ratio; PHBS = posterior hypophyseal bright spots; PST =
pituitary stalk thickening; PSW =
pituitary stalk width.