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Our purpose was to measure the size of the pons and cerebellum in preterm babies with periventricular leukomalacia (PVL), and to study their relationship with the severity of PVL and with perinatal risk factors. We examined 33 premature children, mean gestational age 31 weeks, range 26-36 weeks with PVL on MRI, and 27 full-term controls. On MRI at 0.4-5.5 years (mean 1.4 years) we measured the area of the corpus callosum and vermis, the anteroposterior diameter of the pons and the volume of the cerebellum. The area of the corpus callosum was used as a marker of white matter loss and PVL severity. All regional brain measurements except that of the vermis were significantly lower in patients than controls: corpus callosum (mm(2)): 239.6+/-92.5 vs 434.8+/-126.8, P

Tumefactive multiple sclerosis is a rare entity in children. Differential diagnosis includes other mass lesions such as neoplasm and abscess. A case of tumefactive multiple sclerosis in a child is presented. The open-ring pattern of enhancement on conventional MRI and magnetisation transfer imaging was important for the initial diagnosis and the evaluation of the course of the disease. Neuroradiology

In transfusion-dependent beta-thalassemia major, increased iron deposition in the pituitary gland has a cytotoxic effect leading mainly to hypogonadotropic hypogonadism. Our purpose was to assess in these patients the height of the pituitary gland and to evaluate whether it represents a marker of pituitary gland function. In 29 patients with beta-thalassemia major and 35 age- and gender-matched controls the pituitary gland height was evaluated in a midline sagittal scan using a spin echo T1 -weighted (500/20 TR/TE) sequence. In all patients, an extensive endocrine evaluation was performed, including measurements of spontaneous and stimulated levels of gonadotropins, thyroid hormones, growth hormone, insulin-like growth factor, and adrenal hormones. The pituitary gland height was lower in thalassemic patients with hypogonadotropic hypogonadism (n = 15) (mean 3.48; SD 0.46) than in the age- and gender-matched controls (mean 6.29; SD 0.77), (P0.001). No statistically significant difference was found between thalassemic patients without hormone dysfunction (n = 14) (mean 5.34; SD 1.52) and age- and gender-matched controls (mean 5.91; SD 1.06). We conclude that in thalassemic patients the pituitary gland height is an additional marker of pituitary gland function and might be useful in clinical management.

Our purpose was to determine the pituitary gland signal of premature neonates and infants. We retrospectively measured, in a midline sagittal T1-weighted MRI scan, the pituitary signal of 121 premature infants (mean gestational age: 32.8 weeks, mean chronological age: 6.9 months, mean corrected age: 5.2 months). The relative signal intensity of the adenohypophysis and neurohypophysis was measured as (A-V)/V and (P-V)/V, respectively (where A, P, V are the mean signal intensities of the adenohypophysis, neurohypophysis and vermis white matter, respectively). On visual inspection the adenohypophysis was rated relative to the vermis white matter (VWM) and scored as hyperintense (grade 3), isointense (grade 2) and hypointense (grade 1). (A-V)/V and (P-V)/V had a negative correlation with chronological age (r=-0.38, r=-0.35, respectively, P

Pituitary secretory activity is different in premature and full-term infants. The height of the pituitary is a marker of its secretory activity. Our purpose was to use MRI to measure height of the pituitary of premature infants and to compare it with full-term controls. The height was measured on a midline sagittal T1-weighted image in 86 premature infants (gestational age 26-36.9 weeks, mean 32.3+/-2.85 weeks, corrected age 0.33-2 years, mean 0.76+/-0.42 years) and in 70 age- and sex-matched full-term controls. The children were was divided into four age groups: A:or =0.5 years; B: 0.51-1.0 year; C: 1.01-1.5 years; and D: 1.51-2.00 years. The gland was significantly (P0.01) higher in the preterm infants than in the controls (3.88+/-0.61 vs 3.31+/-0.64 mm). In the preterm group no significant difference was found between children small or appropriate for gestational age or between those with and without periventricular leukomalacia. Pituitary height by age group was: A: 3.71+/-0.57, B: 3.81+/-0.56, C: 4.09+/-0.68; and D:4.45+/-0.57 mm; statistically significant (P0.01) differences were found between groups A and D and B and D. The pituitary is thus higher in premature than in full-term controls and shows a trend to increase after the first year of corrected-age life.

Subarachnoid haemorrhage due to cauda equina tumour is rare. We report two myxopapillary ependymomas of the conus terminalis, presenting with in this way. Rims of low signal were observed at their upper and lower borders, mainly on T2-weighted images. This finding has been described in ependymomas of the cervical region but not, to our knowledge, in myxopapillary ependymomas of the conus terminalis. Neuroradiology

Magnetisation transfer (MT) techniques provide tissue contrast depending mainly on the concentration of macromolecules. Because many macromolecules are involved in the secretory activity of the pituitary gland, MT techniques might be useful in the study of pituitary gland disorders. Our purpose was to establish a quantitative database of the MT ratio (MTR) of the normal adenohypophysis and to see whether there are age- and sex-related differences. Using a three-dimensional gradient-echo sequence for MT we studied the adenohypophysis in 56 males and 61 females aged 7 months-77 years; postsaturation images were obtained using an on-resonance binomial prepulse. The images were normal in all but three patients, two with meningiomas, one with a schwannoma). Adenohypophyseal MTR increased in both sexes up to 19 years of age (r = 0.47 males, 0.39 females, P < 0.05). In men after 20 years and in women from 20-49 years MTR decreased (r = -0.68, P < 0.001, r = -0.46, P < 0.05, respectively). In women aged 50-59 years the MTR again increased slightly. The MTR in males was slightly higher at all ages except before 9 and after 50 years of age. These differences were not statistically significant except in the 40-49 year group (P < 0.05).