摘要
目的:探讨鞍区囊性病变的影像学表现,以提高鉴别诊断能力。方法:回顾性分析62例经手术或临床随访确诊的鞍区囊性病变,包括30例垂体腺瘤,18例Rathke囊肿,5例囊性颅咽管瘤,2例垂体脓肿,5例空蝶鞍,鞍旁囊性听神经瘤、蝶鞍动脉瘤各1例,所有病例均行MRI扫描。结果:垂体腺瘤以囊实性为主,不均匀强化,部分囊液因高蛋白或出血呈T1WI高信号;Rathke囊肿呈单囊,多位于鞍上,无强化,垂体受压变形;空炮蝶鞍垂体呈线样受压改变;囊性颅咽管囊壁伴钙化,囊内信号混杂,垂体受压变形但均可显示;垂体脓肿常累及整个垂体,边界不清,见液平面,呈环状强化;动脉瘤血管检查可见病变与相应动脉相连;囊性听神经瘤位于鞍旁,内耳道扩大。讨论:根据鞍区囊性病变的MRI影像特征及临床表现多可做出准确诊断。
Objective： To investigate the imaging findings of cystic lesions in the sellar region, and to improve the ability of differential diagnosis. Methods： A retrospective analysis was performed for 62 patients with cystic lesions in the sellar region confirmed by surgery or clinical follow-up, and among these patients, 30 had pituitary adenoma, 18 had Rathke cyst, 5 had cystic craniopharyngioma, 2 had pituitary abscess, 5 had empty sella, and one each had parasellar cystic acoustic neuroma and aneurysm in the sella turcica. All patients underwent magnetic resonance imaging （MRI） scan. Results： Pituitary adenomas were mainly solid-cystic with heterogeneous enhancement, and some part of the cystic fluid showed T1W1 hyperintensity due to high protein or bleeding. Rathke cysts were single and mainly located in the suprasellar region without enhancement, and the pituitary gland was compressed and showed deformity, In the patients with empty sella, the pituitary gland showed linear compression. Cystic craniopharyngioma was accompanied by calcification in the cystic wall with mixed signals inside the cyst, and the pituitary gland was compressed and showed deformity, but it was fully displayed. Pituitary abscess often involved the whole pituitary gland with unclear boundaries, presence of fluid level, and rim enhancement. Vascular examination of aneurysms showed that the lesion was connected with the corresponding artery. Cystic acoustic neuromas were located in the parasellar region with enlargement of the internal acoustic meatus. Conclusions： An accurate diagnosis can be made based on the MRI features and clinical manifestations of cystic lesions in the sellar region.
出处
《西南医科大学学报》
2017年第5期497-500,共4页
Journal of Southwest Medical University
关键词
鞍区
囊性病变
磁共振成像
Sellar region
Cystic lesion
Magnetic resonance imaging
作者简介
沈小程，住院医师，硕士生。E-mail：513091040@qq．com.
