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1、586实用放射学杂志2004年7月第20卷第7期JPractRadiol,July2004,Vol20,No.7鞍旁病变的MR诊断鱼博浪,郭世萍,孙亲利,王斐,张明,范帆(西安交通大学第一医院影像中心,陕西西安710061)摘要:目的通过总结59例鞍旁病变的MR表现,探讨鞍旁病变的MR诊断和鉴别诊断。方法59例鞍旁病变,均行MR平扫检查,41例行MR增强扫描。35例经手术病理证实,24例经临床证实。结果鞍旁脑膜瘤信号和强化表现与其他部位脑膜瘤类似,累及垂体时需要与垂体瘤侵犯海绵窦鉴别。肿瘤从桥小脑角延伸到鞍旁是三叉
2、神经瘤的特点。转移瘤常见于鼻咽癌颅内侵犯。痛性眼肌麻痹表现为海绵窦增大和动眼神经强化。海绵状血管瘤可以呈长T1长T2信号,显著强化。动脉瘤呈流空低信号,可以有血栓形成。结论多数鞍旁病变MR表现有特点,少数需要结合临床进行鉴别诊断。关键词:鞍旁病变;磁共振成像;鉴别诊断中图分类号:R742.;R445.2文献标识码:A文章编号:1002-1671(2004)07-0586-03MRDiagnosisofJuxtasellarDiseasesYUBo-lang,GUOShi-ping,SUNQin-li,WANGFei,ZHANG
3、Ming,FANFan(MedicalImagingCenter,theFirstHospitalofXianJiaotongUniversity,Shaanxi,Xian710061,China)Abstract:ObjectiveToexploreMRdiagnosisanddifferentialdiagnosisofjuxtasellardiseasesbystudyingMRmanifestationsof59casesofjuxtasellardiseases.Methods59casesofjuxtasell
4、ardiseaseswereunderwentbyMRplanscans,amongthem41caseswereexaminedbyMRcontrastscan.35caseswereprovedbyoperationandpathology,24caseswereprovedbyclinicaldata.ResultsThesignalintensityandenhancedmanifestationsofjuxtasellarmeningiomawerethesameasthatofmeningiomalocatedinoth
5、erplace.Itwasneededtodifferentiatejuxtasellarmeningiomainvolvingpituitaryglandfrompituitaryadenomainvolvingcavernoussinus.Thecharacteristicoftrigeminalnervetumorwasthatthetumorextendedfromponscerebellumangletojuxtasella.Metastaseswerecommonlyseeninencephalicinvasionbyn
6、asopharyngealcancinoma.Algeticophthalmoplegiamanifestedtheenlargementofcavernoussinusandenhancementofoculomotornerve.CavernoushemangiomamayshowlongT1andlongT2signalandprominentenhancement.Aneurysmmightshowsignallossandformationofthrombus.ConclusionMostofjuxtasellardise
7、aseshavetheirownfeatures,butafewofthemneedtomakedifferentialdiagnosisincombinationwithclinicaldata.Keywords:juxtasellardiseases;MRI;differentialdiagnosis本文对我院近年来经手术病理和临床证实的鞍旁2MR表现病变59例进行总结,主要分析鞍旁各种病变的MR表2.123例鞍旁脑膜瘤MR表现3例肿瘤呈类圆形,现特点,探讨鞍旁病变的鉴别诊断。20例形态不规则。6例肿瘤侵犯鞍内,同时有垂体
8、腺和蝶鞍增大。T1WI上18例呈等信号,5例呈稍低信1材料与方法号。8例T2W呈等信号,15例信号稍高于脑实质。191.1研究对象本组鞍旁病变59例,男32例,女27例肿瘤包绕颈内动脉。增强扫描肿瘤均
