{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:15:48Z","timestamp":1789049748147,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Brain MRI is widely performed in children with short stature or suspected growth hormone deficiency(GHD) to exclude hypothalamic\u2013pituitary (HP) pathology, yet its diagnostic yield in routine practice is uncertain. We aimed to evaluate the prevalence, clinical significance, and distribution of HP and extrahypothalamic abnormalities in a large real\u2010world pediatric referral cohort, and to assess the incremental diagnostic value of gadolinium contrast and pituitary morphometry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 330 children (mean age: 9.2\u2009\u00b1\u20093.7 years; 60.3% boys) who underwent pituitary\u2010protocol brain MRI between 2011 and 2024. Clinical presentation was classified as isolated short stature\/suspected GHD or complex endocrine\/neurologic features. Imaging findings were categorized as HP or non\u2010HP, and classified as clinically significant (major\/minor) or non\u2010significant. Pituitary height was measured relative to age\u2010 and sex\u2010adjusted norms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clinically significant abnormalities were identified in 22 children (6.7%), including four major lesions (1.2%). HP abnormalities were present in 30 patients (9.1%), with 11 (3.3%) clinically significant: eight microadenomas and three large sellar masses. Non\u2010HP abnormalities occurred in 41 children (12.4%); 11 (3.3%) were clinically significant, including white matter changes, Chiari I malformation, and subependymal heterotopia. A suspected thalamic tumor represented the only major non\u2010HP lesion. Notably, most major abnormalities occurred in children without complex endocrine presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among children evaluated for short stature or suspected GHD, clinically significant MRI abnormalities were uncommon and major HP pathology was rare. Nonetheless, the few high\u2010impact lesions identified carried critical management implications, including contraindication to GH therapy and neurosurgical referral, often in children with otherwise uncomplicated presentations. In a pediatric population where delayed diagnosis may adversely affect growth, pubertal development, and treatment safety, these findings support a risk\u2010adapted imaging strategy that preserves diagnostic vigilance while promoting responsible resource utilization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.70206","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:56:36Z","timestamp":1789048596000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Yield of Brain MRI in Pediatric Short Stature: Hypothalamic\u2013Pituitary Lesions and Incidental Findings in Real\u2010World Practice"],"prefix":"10.1111","author":[{"given":"Mustafa","family":"Zubeidat","sequence":"first","affiliation":[{"name":"Gray Faculty of Medical and Health Sciences Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamer","family":"Sobeh","sequence":"additional","affiliation":[{"name":"Section of Neuroradiology Division of Diagnostic Imaging, Sheba Medical Center Ramat\u2010Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shai","family":"Shrot","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical and Health Sciences Tel Aviv University Tel Aviv Israel"},{"name":"Section of Neuroradiology Division of Diagnostic Imaging, Sheba Medical Center Ramat\u2010Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"issue":"1","key":"e_1_2_10_2_1","first-page":"43","article-title":"Evaluation of Short and Tall Stature in Children","volume":"92","author":"Barstow C.","year":"2015","journal-title":"American Family Physician"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","DOI":"10.1155\/2022\/3111585","article-title":"MRI Findings of Pituitary Gland in Growth Hormone\u2010Deficient Children and Their Correlation With Growth Hormone Peak During Growth Hormone Stimulation Tests","volume":"2022","author":"Chen J.","year":"2022","journal-title":"Contrast Media & Molecular Imaging"},{"issue":"1","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000502231","article-title":"Diagnosis, Genetics, and Therapy of Short Stature in Children: A Growth Hormone Research Society International Perspective","volume":"92","author":"Collett\u2010Solberg P. F.","year":"2019","journal-title":"Hormone Research in Paediatrics"},{"issue":"7","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1007\/s00234-021-02665-3","article-title":"Prevalence of Brain MRI Findings in Children With Nonacquired Growth Hormone Deficiency: A Systematic Review and Meta\u2010Analysis","volume":"63","author":"Hwang J.","year":"2021","journal-title":"Neuroradiology"},{"issue":"2","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s00247-021-04973-5","article-title":"Gadolinium Retention: Should Pediatric Radiologists Be Concerned, and How to Frame Conversations With Families","volume":"52","author":"Noda S. M.","year":"2022","journal-title":"Pediatric Radiology"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"l6459","DOI":"10.1136\/bmj.l6459","article-title":"Does General Anesthesia Affect Neurodevelopment in Infants and Children?","volume":"367","author":"McCann M. E.","year":"2019","journal-title":"BMJ"},{"issue":"4","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1159\/000509366","article-title":"Questioning the Value of Brain Magnetic Resonance Imaging in the Evaluation of Children With Isolated Growth Hormone Deficiency","volume":"93","author":"Oren A.","year":"2020","journal-title":"Hormone Research in Paediatrics"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ghir.2021.101427","article-title":"The Necessity of Magnetic Resonance Imaging in the Evaluation of Pediatric Growth Hormone Deficiency: Lessons From a Large Academic Center","volume":"60","author":"Mamilly L.","year":"2021","journal-title":"Growth Hormone & IGF Research"},{"issue":"11","key":"e_1_2_10_10_1","first-page":"1071","article-title":"Measures of Pituitary Gland and Stalk: From Neonate to Adolescence","volume":"27","author":"Sari S.","year":"2014","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"issue":"2","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1530\/EJE-12-0801","article-title":"Magnetic Resonance Imaging of CNS in 15,043 Children With GH Deficiency in KIGS (Pfizer International Growth Database)","volume":"168","author":"Maghnie M.","year":"2013","journal-title":"European Journal of Endocrinology"},{"issue":"2","key":"e_1_2_10_12_1","article-title":"Auxological, Clinical, and MRI Abnormalities in Pediatric Patients With Isolated Growth Hormone Deficiency","volume":"16","author":"Alyahyawi N. Y.","year":"2024","journal-title":"Cureus"},{"issue":"11","key":"e_1_2_10_13_1","first-page":"3990","article-title":"Consensus Guidelines for the Diagnosis and Treatment of Growth Hormone (GH) Deficiency in Childhood and Adolescence: Summary Statement of the GH Research Society","volume":"85","author":"Growth Hormone Research Society","year":"2000","journal-title":"The Journal of Clinical Endocrinology & Metabolism"},{"issue":"2","key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/cen.14353","article-title":"Pituitary Incidentalomas in Paediatric Population: Incidence and Characteristics","volume":"94","author":"Shareef M.","year":"2021","journal-title":"Clinical Endocrinology"},{"issue":"4","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"R171","DOI":"10.1530\/EJE-15-1272","article-title":"Management of Endocrine Disease: Pituitary \u2018Incidentaloma\u2019: Neuroradiological Assessment and Differential Diagnosis","volume":"175","author":"Vasilev V.","year":"2016","journal-title":"European Journal of Endocrinology"},{"issue":"4","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.lpm.2021.104081","article-title":"Pituitary Incidentaloma","volume":"50","author":"Constantinescu S. M.","year":"2021","journal-title":"La Presse m\u00e9dicale"},{"issue":"12","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"5906","DOI":"10.1210\/jc.2019-01252","article-title":"Clinical Course of Nonfunctional Pituitary Microadenoma in Children: A Single\u2010Center Experience","volume":"104","author":"Thaker V. V.","year":"2019","journal-title":"The Journal of Clinical Endocrinology & Metabolism"},{"issue":"3","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1159\/000489456","article-title":"Incidence and Outcomes of Pituitary Microadenomas in Children With Short Stature\/Growth Hormone Deficiency","volume":"90","author":"Derrick K. M.","year":"2018","journal-title":"Hormone Research in Paediatrics"},{"issue":"5","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1007\/s00247-018-4070-7","article-title":"Pituitary Height at Magnetic Resonance Imaging in Pediatric Isolated Growth Hormone Deficiency","volume":"48","author":"Dumrongpisutikul N.","year":"2018","journal-title":"Pediatric Radiology"},{"key":"e_1_2_10_20_1","doi-asserted-by":"crossref","first-page":"9473","DOI":"10.12659\/MSM.911977","article-title":"Relevance of Pituitary Gland Magnetic Resonance Imaging Results With Clinical and Laboratory Findings in Growth Hormone Deficiency","volume":"24","author":"Kara \u00d6.","year":"2018","journal-title":"Medical Science Monitor"},{"issue":"2","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.4103\/njcp.njcp_555_24","article-title":"MRI\u2010Based Evaluation of Pituitary Size and Volume in Children With Idiopathic Growth Hormone Deficiency","volume":"28","author":"Kaba I.","year":"2025","journal-title":"Nigerian Journal of Clinical Practice"},{"issue":"5","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1159\/000519031","article-title":"Is Gadolinium Contrast Necessary for Pituitary MRI in the Evaluation of Pediatric Short Stature and Growth Hormone Deficiency?","volume":"94","author":"Almaghraby A.","year":"2021","journal-title":"Hormone Research in Paediatrics"},{"issue":"10","key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"2751","DOI":"10.1007\/s00701-022-05225-7","article-title":"Prevalence of Incidental Intracranial Findings on Magnetic Resonance Imaging: A Systematic Review and Meta\u2010Analysis","volume":"164","author":"Sunny D. E.","year":"2022","journal-title":"Acta Neurochirurgica"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.70206","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cen.70206","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.70206","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:56:39Z","timestamp":1789048599000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.70206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":22,"alternative-id":["10.1111\/cen.70206"],"URL":"https:\/\/doi.org\/10.1111\/cen.70206","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"assertion":[{"value":"2025-11-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"cen.70206"}}