6:15 PM - 7:15 PM
[II-JCKEOP01-07] Enlargement of the pituitary gland in patients after Fontan operation: another portal circulation
<Abstract>
Objective: There are two portal circulation systems in a human body, one is in the liver, and another is in the pituitary. Recently, it has been widely recognized about problems on the liver in patients after Fontan operation. However, it is not known about the pituitary. The aim of this study is to investigate the size of the pituitary after Fontan operation.
Methods: We investigated the size of the pituitary using the MRI brain imaging in the 40 adolescent patients after Fontan operation. We measured the height (H) and length (L) of the pituitary in sagittal section, and the width (W) of that in coronal section. We estimated the volume of that as follows: (H×L×W)×1/2. We compared them between the enrolled patients and the 60 age-matched control subjects without structural disorder.
Results: Fontan operation was performed at the median age of 3.3 years (1.6-5.7). The MRI was undertaken at the median age of 9.3 years (7.2-22.0). The size of the pituitary was larger than that of controls (H 7.5±1.3mm vs. 5.9±1.2mm, L 9.7±1.3mm vs. 8.0±1.3mm, W 12.9±1.8mm vs. 11.0±1.9mm, p<0.01, respectively). The volume of that was 935.0±216.8 mm3, which was enlarged nearly twice larger than the controls (534.5±208.7mm3) (p<0.01). When examining the correlation between each clinical data and pituitary volume, there were positive correlations between age (R=0.46), central venous pressure (R=0.51) and the pituitary volume.
Conclusion: Enlargement of the pituitary may develop due to high central venous pressure. We should pay attention to pituitary function in patients after Fontan operation.
Objective: There are two portal circulation systems in a human body, one is in the liver, and another is in the pituitary. Recently, it has been widely recognized about problems on the liver in patients after Fontan operation. However, it is not known about the pituitary. The aim of this study is to investigate the size of the pituitary after Fontan operation.
Methods: We investigated the size of the pituitary using the MRI brain imaging in the 40 adolescent patients after Fontan operation. We measured the height (H) and length (L) of the pituitary in sagittal section, and the width (W) of that in coronal section. We estimated the volume of that as follows: (H×L×W)×1/2. We compared them between the enrolled patients and the 60 age-matched control subjects without structural disorder.
Results: Fontan operation was performed at the median age of 3.3 years (1.6-5.7). The MRI was undertaken at the median age of 9.3 years (7.2-22.0). The size of the pituitary was larger than that of controls (H 7.5±1.3mm vs. 5.9±1.2mm, L 9.7±1.3mm vs. 8.0±1.3mm, W 12.9±1.8mm vs. 11.0±1.9mm, p<0.01, respectively). The volume of that was 935.0±216.8 mm3, which was enlarged nearly twice larger than the controls (534.5±208.7mm3) (p<0.01). When examining the correlation between each clinical data and pituitary volume, there were positive correlations between age (R=0.46), central venous pressure (R=0.51) and the pituitary volume.
Conclusion: Enlargement of the pituitary may develop due to high central venous pressure. We should pay attention to pituitary function in patients after Fontan operation.