Pituitary gland: MR imaging of physiologic hypertrophy in adolescence

The size and shape of pituitary glands in 169 children, adolescents, and young adults were analyzed with T1-weighted sagittal magnetic resonance (MR) images. In patients younger than 12 years old, no pituitary gland was found to be more than 6 mm in height. In adolescents, definite evidence for physiologic (pubertal) pituitary hypertrophy was seen in both sexes, although it was much more prominent in girls. The pituitary glands of four of 32 teenage girls measured 8-10 mm, but no teenage boy had a gland taller than 7 mm. Young adults aged 21-30 years had significantly (P < .05) smaller glands than teenagers of the same sex. Significant (P = .0001) variations in the shape of the pituitary glands according to patient age and sex were also noted. Convex upper margins were seen in 56% of teenage girls, while this shape was noted in only 18% of the remaining patients of either sex. In eight of 32 teenage girls (25%) the pituitary glands were nearly spherical on sagittal images; this shape was not recorded in any other group. The normal maturation sequence of the pituitary gland apparently involves a period of physiologic hypertrophy in teenagers. This is manifest in girls by a significant change in both pituitary size and shape, while the glands of boys undergo a transformation in size only.