Neonatal Pituitary Gland

This is a one month-old female with congenital hypothyroidism, hypoplasia of the thyroid gland, elevated TSH (eight times normal value), elevated FSH and LH (four times normal values), normal GH, without diabetes insipid. She is now being treated for the hypothyroidism, and we are waiting for hormonal follow-up; MRI follow-up in three to six month follow-up.

Has anyone an explanation for the focal bright spot on T1-weighted images in the cranial portion of the pituitary stalk, just down the median eminence, in the presence of a normal neurohypophysis?

Is it an “ectopic” adenohypophysis?

Is this a thin pituitary stalk in pituitary gland hypoplasia?

What will happen at follow-up?

It is  the start of  an infiltrative disease?

…It is simply that I do not know the normal and physiological behavior of the pituitary gland?…

A, Sagittal T1

B, Coronal T1C, Coronal T2D, Sagittal Gd-T1

Best regards to all of You!

Neonatal Pituitary Gland
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Alfonso CERASE • Unit of Neuroimaging and Neurointervention, Department of Neurosciences Az. Osp. Univ. Senese, Policlinico "Santa Maria alle Scotte", Siena, Italy