刘伟平 李 元 伍宝伟 李文锋 唐宜繁 :东莞市大朗医院 广东东莞 523770 低场强MR诊断垂体瘤的价值 刘伟平 李 元 伍宝伟 李文锋 唐宜繁 LOW FIELD STRENGTH MR DIAGNOSIS OF PITUITARY TUMORS LIU Weiping, LI Yuan, WU Baowei, et al 【摘 要】 目的 总结分析28例垂体瘤的低场强MRI表现。方法 使用0.23T磁共振扫描仪,回顾性28例经手术和病理证实的垂体瘤的MRI表现,结合相关文献,对MRI表现进行归纳。结果 垂体巨腺瘤23例在T1WI上为低、等信号,T2WI呈中等高、高信号,占位效应明显,常向上累及视交叉(69%)及向两侧侵袭海绵窦(43%);5例微腺瘤在T1WI上多为低、等信号,T2WI为等高信号。结论 低场强MRI对垂体瘤有很高的诊断价值,对形态学改变不明显的垂体微腺瘤,结合GD-DTPA可获得满意诊断结果。 【关键词】 垂体瘤,磁共振成像,低场强 【Abstract】 Objective To analyze and summarize the MRI features of 28 pituitary adenomas under the low field intensity. Methods 28 cases of pituitary adenomas in MRI features were analyzed retrospectively by using 023T MRI. To summarize the MRI features by referring some related specialities. Results 23 cases of Giant pituitary adenoma were presented to be low signal or isosignal in T1WI, middle signal or high signal in T2WI, with obvious mass effect, suggested to be 69% chiasma opticum by upward cumulation and 43% cavernous sinus hitted from two sides. 5 cases of microadenoma were presented to be low signal or isosignal in T1WI and high signal in T2WI. Conclusion MRI in low field intensity played an important role in diagnostic value in pituitary adenomas. As to pituitary microadenoma with little change in morphology, we can obtain the satisfactory conclusion by referring GD-DTPA. 【Key words】 Pituitary adenomas, MRI, Low field intensity 【Author′s address】 Dalang Hostipal, Dongguan, Guangdong,523770, PRC doi:10.3969/j.issn.1671-332X.2015.02.028 垂体瘤是颅内好发肿瘤之一,发病率8%~20%[1]。MRI具有无创伤性、软组织对比度好、无骨伪影及三维成像等优点,是诊断垂体瘤的理想的方法。本文回顾性分析我院2006年6月~2014年8月间28例经手术和病理证实的垂体瘤的MRI表现,复习相关文献,对MRI表现进行总结分析。 1 材料与方法 经手术和病理证实的28例垂体腺瘤中,男11例,女17例。年龄13~69岁,平均3671岁。按肿瘤大小分为巨腺瘤组(>10 mm)和微腺瘤组(3~10 mm),巨腺瘤组23例,微腺瘤组5例。主要临床表现:头痛、头晕、视力下降、面麻、闭经泌乳、肢端肥大等。 采用Marconi023T常导开放式MR机进行扫描,为头线圈,常规行冠状面自旋回波T1WI、T2WI及矢状T2WI扫描。冠状T1WI:TR480/TE16ms、T2WI:TR4000/TE100ms,矢状T2WI:TR4900/TE110ms,层厚:3 mm,矩阵:256×256,FOV:220 mm。20例行GD-DTPA三维增强扫描,其中5例为微腺瘤。 2 结果 2.1 巨腺瘤组 23例肿瘤表现为圆形或椭圆形,部分呈分叶状,边界清楚。15例肿瘤突破鞍隔向鞍上池生长(7例出现束腰征,占4667%),见图1、图2;11例向下破坏鞍底进入蝶鞍(3例有斜坡骨质破坏,占2727%):8例向两侧侵犯海绵窦、推压或包裹颈内动脉;18例肿块压迫视交叉或视束;5例压迫下丘脑及第三脑室。
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