Resonancia magnética en niños y adolescentes con diabetes insípida central: hallazgos al diagnóstico y durante su seguimiento
Magnetic resonance imaging in central diabetes insipidus in children and adolescents. findings at diagnosis and during follow-upa
I. Bergadá
, J.J. Heinrich
Autor para correspondencia
cedie@pccp.com.ar
Dr. I Bergadá. División de Endocrinología. Hospital de Niños Ricardo Gutiérrez. Gallo 1330. 1425 Buenos Aires. Argentina.
Dr. I Bergadá. División de Endocrinología. Hospital de Niños Ricardo Gutiérrez. Gallo 1330. 1425 Buenos Aires. Argentina.
División de Endocrinología. Hospital de Niños Ricardo Gutiérrez. Buenos Aires. Argentina.
Leído
11805
Vecesse ha leído el artículo
3376
Total PDF
8429
Total HTML
Compartir estadísticas
array:23 [ "pii" => "S1695403300774248" "issn" => "16954033" "doi" => "10.1016/S1695-4033(00)77424-8" "estado" => "S300" "fechaPublicacion" => "2000-08-01" "aid" => "77424" "copyright" => "Asociación Española de Pediatría" "copyrightAnyo" => "2000" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2000;53:100-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5622 "formatos" => array:3 [ "EPUB" => 97 "HTML" => 4521 "PDF" => 1004 ] ] "itemSiguiente" => array:18 [ "pii" => "S169540330077425X" "issn" => "16954033" "doi" => "10.1016/S1695-4033(00)77425-X" "estado" => "S300" "fechaPublicacion" => "2000-08-01" "aid" => "77425" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2000;53:106-11" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4233 "formatos" => array:3 [ "EPUB" => 73 "HTML" => 3587 "PDF" => 573 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Demanda asistencial neuropediátrica en un hospital general" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "106" "paginaFinal" => "111" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Demand For Neuropediatric Healthcare In A General Hospital" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Herrera Martín, R. Gracia Remiro, C. Santana Rodríguez, A. Jiménez Moya, J. Ayala Curiel, P. Cuadrado Bello" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Herrera Martín" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Gracia Remiro" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Santana Rodríguez" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Jiménez Moya" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Ayala Curiel" ] 5 => array:2 [ "nombre" => "P." "apellidos" => "Cuadrado Bello" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S169540330077425X?idApp=UINPBA00005H" "url" => "/16954033/0000005300000002/v1_201307051512/S169540330077425X/v1_201307051512/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1695403300774236" "issn" => "16954033" "doi" => "10.1016/S1695-4033(00)77423-6" "estado" => "S300" "fechaPublicacion" => "2000-08-01" "aid" => "77423" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2000;53:94-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 6182 "formatos" => array:3 [ "EPUB" => 92 "HTML" => 5208 "PDF" => 882 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Meningitis neumocócica en la infancia. Revisión de 28 casos" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "94" "paginaFinal" => "99" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pneumococcal meningitis in children. review of 28 cases" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Mencía Bartolomé, J. Casado Flores, C. Marín Barba, M. González-Vicent, M.J. Ruiz López" "autores" => array:5 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Mencía Bartolomé" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Casado Flores" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Marín Barba" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "González-Vicent" ] 4 => array:2 [ "nombre" => "M.J." "apellidos" => "Ruiz López" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403300774236?idApp=UINPBA00005H" "url" => "/16954033/0000005300000002/v1_201307051512/S1695403300774236/v1_201307051512/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Resonancia magnética en niños y adolescentes con diabetes insípida central: hallazgos al diagnóstico y durante su seguimiento" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "100" "paginaFinal" => "105" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "I. Bergadá, J.J. Heinrich" "autores" => array:2 [ 0 => array:4 [ "nombre" => "I." "apellidos" => "Bergadá" "email" => array:1 [ 0 => "cedie@pccp.com.ar" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J.J." "apellidos" => "Heinrich" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "División de Endocrinología. Hospital de Niños Ricardo Gutiérrez. Buenos Aires. Argentina." ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Dr. I Bergadá. División de Endocrinología. Hospital de Niños Ricardo Gutiérrez. Gallo 1330. 1425 Buenos Aires. Argentina." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Magnetic resonance imaging in central diabetes insipidus in children and adolescents. findings at diagnosis and during follow-upa" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-02-29" "fechaAceptado" => "2000-05-31" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186420" "palabras" => array:4 [ 0 => "Diabetes insípida" 1 => "Imagen por resonancia magnética" 2 => "Neurohipófisis" 3 => "Germinoma" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec186419" "palabras" => array:4 [ 0 => "Diabetes insipidus" 1 => "Magnetic resonance imaging" 2 => "Neu-rohypophysis" 3 => "Germinoma" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La ausencia de la señal hiperintensa generada por la neurohipófisis en la imagen por resonancia magnética (RM) es considerada por algunos autores como evidencia de disfunción hipotalamohipofisaria. Con el objetivo de valorar la utilidad de la RM, se analizan los hallazgos al diagnóstico y durante el seguimiento clínico de 14 niños con diabetes insípida central (DIC).</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se analizaron las imágenes obtenidas por RM de 14 pacientes (4 mujeres, 10 varones; edad media de 8,5 años) que consultaron por poliuria y polidipsia y cuyo diagnóstico fue diabetes insípida central. El tiempo medio de evolución desde el inicio de la poliuria hasta la primera RM fue de 1,5 años. En 11 pacientes se efectuó más de una RM durante el seguimiento. El tiempo medio de seguimiento de los pacientes fue de 2,8 años.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En 10 pacientes el diagnóstico fue DIC idiopática, en 3 fue secundaria a un tumor hipotalámico, y un paciente presentó una histiocitosis. En un paciente con DIC idiopática la señal hiperintensa estuvo presente al diagnóstico, desapareciendo en el curso del seguimiento a los 15 meses del estudio inicial. Cuatro de los pacientes con DIC idiopática presentaron engrosamiento del tallo hipofisario en algún momento de la evolución. En los 3 pacientes con DIC asociada a tumor de células germinales, la señal hiperintensa estaba ausente en dos de ellos y en un paciente se encontraba ectópica junto con engrosamiento del tallo hipofisario. En el paciente con histiocitosis sólo se observó ausencia de la señal hiperintensa.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">1) La mayoría de los pacientes con DIC presentaron anomalía en la señal hiperintensa característica de la neurohipófisis en el momento del diagnóstico de la enfermedad; sin embargo, en uno de nuestros pacientes dicha señal desapareció durante el seguimiento, por ello la presencia de la señal hiperintensa no descarta el diagnóstico de DIC. 2) Si bien el engrosamiento del tallo hipofisario puede ser indicador de un proceso inflamatorio inespecífico, su presencia obliga a profundizar los estudios en el momento del diagnóstico así como durante la evolución para descartar patología infiltrativa o tumoral.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Aim</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The absence of the hyperintense signal of the posterior pituitary in magnetic resonance imaging (MRI) is considered by some authors to be evidence of neurohypophy-seal dysfunction. To evaluate the utility of MRI as a complementary diagnostic aid in patients with central diabetes insipidus (CDI), we studied the MR images of pediatric patients at diagnosis and during follow-up.</p> <span class="elsevierStyleSectionTitle">methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">MR images from 14 patients (4 females, 10 males; mean age 8.5 years) who were referred for polyuria and polydipsia and whose diagnosis was central diabetes insipidus (CDI) were analyzed. Mean time of evolution from onset of polyuria until the first MRI was 1.5 years. In 11 patients more than one MR image was obtained during follow-up. Mean time of follow-up was 2.8 years.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In 10 patients CDI was idiopathic, in 3 it was secondary to a hypothalamic tumor and in 1 it was secondary to histiocytosis. In one patient with idiopathic CDI, the hyperintense signal was present at diagnosis but disappeared during the following 15 months. Four of the patients with idiopathic CDI developed thickening of the pituitary stalk, some at their diagnosis and others during follow-up. Of the three patients in whom CDI was secondary to a germinoma, the hyperintense signal was absent in two of them, while in one the signal was ectopic and associated with a thickened pituitary stalk. In the patient with histiocytosis, the hyperintense signal was absent at diagnosis.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">1. In most of the patients with CDI the hyperintense signal of the posterior pituitary was absent at diagnosis; however in one patient this signal disappeared during follow-up and consequently its presence does not rule out a diagnosis of CDI. 2. Although a thickened pituitary stalk could reflect only a non-specific, transient inflammatory process, its presence makes ruling out tumoral or infiltrative disease obligatory.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trastornos de la hipófisis posterior" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "I. Bergadá" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Tratado de endocrinología pediátrica" "paginaInicial" => "483" "paginaFinal" => "491" "edicion" => "(2<span class="elsevierStyleSup">a</span>)" "serieFecha" => "1997" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Central diabetes insipidus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N.G. Greger" 1 => "R.T. Kirkland" 2 => "G.W. Clayton" 3 => "J.L. Kirkland" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ajdc" "fecha" => "1986" "volumen" => "140" "paginaInicial" => "551" "paginaFinal" => "554" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3706234" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Role of magnetic resonance imaging in hypot-halamic-pituitary disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Zucchini" 1 => "B. Di Natale" 2 => "A. Ambrosetto" 3 => "G. De Angelis" 4 => "E. Cacciari" 5 => "G. Chiumello" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Horm Res" "fecha" => "1995" "volumen" => "44" "paginaInicial" => "8" "paginaFinal" => "14" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8719434" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MR Imaging of the brain in patients with diabetes insipidus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Tien" 1 => "J. Kucharczyk" 2 => "W. Kucharczyk" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ajnr" "fecha" => "1991" "volumen" => "12" "paginaInicial" => "533" "paginaFinal" => "542" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2058510" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Thickened pituitary stalk on magnetic resonance imaging in children with central diabetes insipidus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Leger" 1 => "A. Velasquez" 2 => "C. Garel" 3 => "M. Hassan" 4 => "P. Czernichow" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jcem.84.6.5745" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "1999" "volumen" => "84" "paginaInicial" => "1954" "paginaFinal" => "1960" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10372693" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Posterior lobe of pituitary in diabetes insipidus: MR findings" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Fujisawa" 1 => "K. Nishimura" 2 => "R. Asato" 3 => "K. Togashi" 4 => "K. Itoh" 5 => "S. Noma" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Comput Assist Tomogr" "fecha" => "1987" "volumen" => "11" "paginaInicial" => "221" "paginaFinal" => "225" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3819118" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Posterior pituitary gland: appearence on MR images in normal and pathologic states" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Colombo" 1 => "I. Berry" 2 => "J. Kucharczyk" 3 => "W. Kucharczyk" 4 => "J. De Groot" 5 => "T. Larson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiology.165.2.3659370" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "1987" "volumen" => "165" "paginaInicial" => "481" "paginaFinal" => "485" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3659370" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hyperintense signal of the posterior pituitary on T1-weighted MR images: an experimental study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "I. Fujisawa" 1 => "R. Asato" 2 => "M. Kawata" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Comput Assist Tomogr" "fecha" => "1989" "volumen" => "13" "paginaInicial" => "371" "paginaFinal" => "377" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2723165" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frecuency and variation of the posterior bright signal on MR images" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B. Brooks" 1 => "T. El Gammal" 2 => "J. Allison" 3 => "W. Hoffman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ajnr" "fecha" => "1989" "volumen" => "10" "paginaInicial" => "943" "paginaFinal" => "948" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2505538" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Water regulation and its disor-ders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Perheentupa" 1 => "P. Czernichow" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Wilkins the diagnosis and treatment of endocrine disorders in childhood and adolescence" "paginaInicial" => "1093" "paginaFinal" => "1140" "edicion" => "(4<span class="elsevierStyleSup">a</span>)" "serieFecha" => "1994" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparison of plasma vasopressin measurement with a standart indirect test in the differncial diagnosis of polyuria" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Zabe" 1 => "G. Robertson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM198112243052601" "Revista" => array:6 [ "tituloSerie" => "Nejm" "fecha" => "1981" "volumen" => "305" "paginaInicial" => "1539" "paginaFinal" => "1546" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7311993" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Correlation between magnetic resonance imaging of posterior pituitary and neurohypophyseal function in chil-dren with diabetes insipidus" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Maghnie" 1 => "A. Villa" 2 => "M. Arico" 3 => "D. Larizza" 4 => "S. Pezzotta" 5 => "G. Beluffi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jcem.74.4.1548343" "Revista" => array:6 [ "tituloSerie" => "Jcem" "fecha" => "1992" "volumen" => "74" "paginaInicial" => "795" "paginaFinal" => "800" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1548343" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MR Imaging of the posterior hypophysis in children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Gudinchet" 1 => "F. Brunelle" 2 => "M.O. Barth" 3 => "V. Taviere" 4 => "R. Brauner" 5 => "R. Rappaport" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ajnr" "fecha" => "1989" "volumen" => "10" "paginaInicial" => "511" "paginaFinal" => "514" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hyperintense pituitary lobe in central diabetes insipidus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Demirci" 1 => "H. Okten" 2 => "J. Gumele" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neuroradiology" "fecha" => "1994" "volumen" => "36" "paginaInicial" => "380" "paginaFinal" => "381" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7936180" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MR imaging of the ectopic bright signal of posterior pituitary regeneration" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. El Gammal" 1 => "B. Brooks" 2 => "W. Hoffman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ajnr" "fecha" => "1989" "volumen" => "10" "paginaInicial" => "323" "paginaFinal" => "328" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2494851" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Idiophatic hypothalamic, diabetes insipidus, pituitary stalk thickened and the occult intracranial ger-minoma in children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.L. Mootha" 1 => "A.J. Barkovich" 2 => "M.M. Grumbach" 3 => "M.S. Edwards" 4 => "S.E. Gitelman" 5 => "S.L. Kaplan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jcem.86.3.7299" "Revista" => array:6 [ "tituloSerie" => "Jcem" "fecha" => "1997" "volumen" => "86" "paginaInicial" => "1362" "paginaFinal" => "1367" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11238533" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Thickened pituitary stalk on MR images in patients with diabetes insipidus and langerghans histiocytosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Tien" 1 => "T. Newton" 2 => "M. McDermott" 3 => "W. Dillon" 4 => "J. Kucharczyk" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ajnr" "fecha" => "1990" "volumen" => "11" "paginaInicial" => "703" "paginaFinal" => "708" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2114753" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lymphocitic infundibuloneurohypophysitis as a cause of central diabetes insipidus" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Imura" 1 => "K. Nakao" 2 => "A. Shimatsu" 3 => "Y. Ogawa" 4 => "T. Sando" 5 => "I. Fujisawa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199309023291002" "Revista" => array:6 [ "tituloSerie" => "Nejm" "fecha" => "1993" "volumen" => "329" "paginaInicial" => "683" "paginaFinal" => "689" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8345854" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diabetes insipidus in Langerghans cell histiocytosis: resuls from the DALHX 83 Study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Grois" 1 => "A. Flutcher-Wolfram" 2 => "B. Heitger" 3 => "G.H. Mostbeck" 4 => "J. Hofmann" 5 => "H. Gadner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Ped Oncology" "fecha" => "1995" "volumen" => "24" "paginaInicial" => "248" "paginaFinal" => "256" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/16954033/0000005300000002/v1_201307051512/S1695403300774248/v1_201307051512/es/main.assets" "Apartado" => array:4 [ "identificador" => "14282" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/16954033/0000005300000002/v1_201307051512/S1695403300774248/v1_201307051512/es/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403300774248?idApp=UINPBA00005H" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 22 | 17 | 39 |
| 2024 Octubre | 101 | 67 | 168 |
| 2024 Septiembre | 94 | 54 | 148 |
| 2024 Agosto | 80 | 106 | 186 |
| 2024 Julio | 72 | 56 | 128 |
| 2024 Junio | 90 | 34 | 124 |
| 2024 Mayo | 83 | 58 | 141 |
| 2024 Abril | 85 | 46 | 131 |
| 2024 Marzo | 55 | 35 | 90 |
| 2024 Febrero | 70 | 49 | 119 |
| 2024 Enero | 80 | 26 | 106 |
| 2023 Diciembre | 86 | 32 | 118 |
| 2023 Noviembre | 92 | 44 | 136 |
| 2023 Octubre | 79 | 34 | 113 |
| 2023 Septiembre | 87 | 42 | 129 |
| 2023 Agosto | 60 | 27 | 87 |
| 2023 Julio | 69 | 45 | 114 |
| 2023 Junio | 69 | 58 | 127 |
| 2023 Mayo | 84 | 49 | 133 |
| 2023 Abril | 59 | 29 | 88 |
| 2023 Marzo | 76 | 36 | 112 |
| 2023 Febrero | 54 | 23 | 77 |
| 2023 Enero | 47 | 28 | 75 |
| 2022 Diciembre | 70 | 18 | 88 |
| 2022 Noviembre | 87 | 62 | 149 |
| 2022 Octubre | 61 | 37 | 98 |
| 2022 Septiembre | 83 | 35 | 118 |
| 2022 Agosto | 52 | 61 | 113 |
| 2022 Julio | 32 | 46 | 78 |
| 2022 Junio | 45 | 43 | 88 |
| 2022 Mayo | 33 | 45 | 78 |
| 2022 Abril | 45 | 58 | 103 |
| 2022 Marzo | 59 | 42 | 101 |
| 2022 Febrero | 63 | 33 | 96 |
| 2022 Enero | 50 | 43 | 93 |
| 2021 Diciembre | 56 | 54 | 110 |
| 2021 Noviembre | 63 | 60 | 123 |
| 2021 Octubre | 86 | 68 | 154 |
| 2021 Septiembre | 78 | 50 | 128 |
| 2021 Agosto | 55 | 30 | 85 |
| 2021 Julio | 57 | 49 | 106 |
| 2021 Junio | 68 | 55 | 123 |
| 2021 Mayo | 64 | 49 | 113 |
| 2021 Abril | 115 | 88 | 203 |
| 2021 Marzo | 116 | 43 | 159 |
| 2021 Febrero | 92 | 23 | 115 |
| 2021 Enero | 73 | 34 | 107 |
| 2020 Diciembre | 68 | 20 | 88 |
| 2020 Noviembre | 56 | 25 | 81 |
| 2020 Octubre | 56 | 21 | 77 |
| 2020 Septiembre | 92 | 15 | 107 |
| 2020 Agosto | 54 | 10 | 64 |
| 2020 Julio | 63 | 19 | 82 |
| 2020 Junio | 57 | 4 | 61 |
| 2020 Mayo | 49 | 38 | 87 |
| 2020 Abril | 82 | 68 | 150 |
| 2020 Marzo | 22 | 25 | 47 |
| 2020 Febrero | 45 | 19 | 64 |
| 2020 Enero | 47 | 19 | 66 |
| 2019 Diciembre | 54 | 34 | 88 |
| 2019 Noviembre | 46 | 8 | 54 |
| 2019 Octubre | 44 | 30 | 74 |
| 2019 Septiembre | 50 | 30 | 80 |
| 2019 Agosto | 42 | 17 | 59 |
| 2019 Julio | 56 | 33 | 89 |
| 2019 Junio | 54 | 32 | 86 |
| 2019 Mayo | 69 | 76 | 145 |
| 2019 Abril | 54 | 76 | 130 |
| 2019 Marzo | 21 | 28 | 49 |
| 2019 Febrero | 29 | 20 | 49 |
| 2019 Enero | 21 | 21 | 42 |
| 2018 Diciembre | 28 | 20 | 48 |
| 2018 Noviembre | 23 | 39 | 62 |
| 2018 Octubre | 30 | 17 | 47 |
| 2018 Septiembre | 12 | 10 | 22 |
| 2018 Junio | 1 | 0 | 1 |
| 2018 Mayo | 5 | 0 | 5 |
| 2018 Abril | 8 | 0 | 8 |
| 2018 Marzo | 7 | 0 | 7 |
| 2018 Febrero | 9 | 0 | 9 |
| 2018 Enero | 14 | 0 | 14 |
| 2017 Diciembre | 10 | 0 | 10 |
| 2017 Noviembre | 14 | 0 | 14 |
| 2017 Octubre | 8 | 0 | 8 |
| 2017 Septiembre | 15 | 0 | 15 |
| 2017 Agosto | 13 | 0 | 13 |
| 2017 Julio | 17 | 2 | 19 |
| 2017 Junio | 15 | 34 | 49 |
| 2017 Mayo | 21 | 22 | 43 |
| 2017 Abril | 19 | 50 | 69 |
| 2017 Marzo | 17 | 58 | 75 |
| 2017 Febrero | 13 | 15 | 28 |
| 2017 Enero | 13 | 15 | 28 |
| 2016 Diciembre | 21 | 14 | 35 |
| 2016 Noviembre | 38 | 13 | 51 |
| 2016 Octubre | 21 | 17 | 38 |
| 2016 Septiembre | 28 | 17 | 45 |
| 2016 Agosto | 32 | 19 | 51 |
| 2016 Julio | 14 | 15 | 29 |
| 2016 Febrero | 4 | 0 | 4 |
| 2016 Enero | 2 | 0 | 2 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Octubre | 1 | 20 | 21 |
| 2015 Agosto | 1 | 13 | 14 |
| 2015 Julio | 11 | 11 | 22 |
| 2015 Junio | 9 | 0 | 9 |
| 2015 Mayo | 14 | 11 | 25 |
| 2015 Abril | 10 | 0 | 10 |
| 2015 Marzo | 5 | 0 | 5 |
| 2015 Febrero | 9 | 0 | 9 |
| 2015 Enero | 11 | 0 | 11 |
| 2014 Diciembre | 8 | 1 | 9 |
| 2014 Noviembre | 8 | 0 | 8 |
| 2014 Octubre | 9 | 1 | 10 |
| 2014 Septiembre | 6 | 5 | 11 |
| 2014 Agosto | 16 | 1 | 17 |
| 2014 Julio | 22 | 1 | 23 |
| 2014 Junio | 23 | 1 | 24 |
| 2014 Mayo | 21 | 0 | 21 |
| 2014 Abril | 14 | 3 | 17 |
| 2014 Marzo | 15 | 7 | 22 |
| 2014 Febrero | 13 | 11 | 24 |
| 2014 Enero | 12 | 9 | 21 |
| 2013 Diciembre | 13 | 12 | 25 |
| 2013 Noviembre | 21 | 6 | 27 |
| 2013 Octubre | 51 | 13 | 64 |
| 2013 Septiembre | 28 | 13 | 41 |
| 2013 Agosto | 22 | 11 | 33 |
| 2013 Julio | 8 | 7 | 15 |
| 2013 Junio | 2 | 3 | 5 |
| 2013 Mayo | 3 | 2 | 5 |
| 2013 Abril | 3 | 2 | 5 |
| 2013 Marzo | 8 | 4 | 12 |
| 2013 Febrero | 44 | 2 | 46 |
| 2013 Enero | 47 | 3 | 50 |
| 2012 Diciembre | 39 | 6 | 45 |
| 2012 Noviembre | 42 | 5 | 47 |
| 2012 Octubre | 37 | 4 | 41 |
| 2012 Septiembre | 6 | 1 | 7 |
| 2012 Agosto | 1 | 1 | 2 |
| 2000 Julio | 2814 | 0 | 2814 |
Mostrar todo
