mri对侵袭性垂体瘤的诊断价值及其临床意义

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1、MRI对侵袭性垂体瘤的诊断价值及其临床意义作者：陈静静常光辉葛艳明隋庆兰【关键词】垂体肿瘤;磁共振成像;诊断　　［摘要］目的研究MRI对侵袭性垂体瘤的诊断价值及其意义。方法29例经手术病理证实的侵袭性垂体瘤病人，使用0.5T的MRI机，选用自旋回波行矢状位、轴位和冠状位T1WI，轴位或冠状位PDWI、T2WI，增强后行矢状位、轴位或冠状位T1WI扫描，并与手术病理资料对比分析。结果肿瘤多为等T1等或长T2信号。增强扫描呈均匀或不均匀强化。向周围组织浸润表现为鞍底受侵下陷，部分肿瘤突入蝶窦;颈动脉包绕，海绵窦受累;鞍隔突破等。10例MRI示0级浸润病例

2、，术中证实均无海绵窦侵犯;14例MRI示1级浸润病例，3例证实肿瘤侵犯海绵窦，并包绕颈内动脉;20例MRI示2级海绵窦侵犯病例，15例证实有海绵窦侵犯;9例MRI示3级浸润病例，8例证实肿瘤侵入海绵窦及颈内动脉外侧间隙;5例MRI示4级浸润病例，术中证实均有海绵窦侵犯，并包绕颈内动脉。结论MRI可为术前诊断垂体瘤的侵袭性提供依据，对选择手术方法和制定治疗方案有重要指导意义。　　［关键词］垂体肿瘤;磁共振成像;诊断　　　　［ABSTRACT］ObjectiveToassessthevalueandsignificanceofMRIimaginginth

3、ediagnosisofinvasive8pituitaryadenoma.MethodsTwenty-ninepatientswithinvasivepituitaryadenomaconfirmedbysurgeryandpathologywereimagedwithsagittal，co-ronalT1WI，orcoronalPDWIandT2WI，sagittal，coronalorT1WIafterGd-DTPAinjection，spin-echosequences，using0.5TMRIscanner.MRIfindingswerea

4、nalyzedandcomparedwithsurgicalandpathologicalresults.ResultsTheMRIappearanceofthetumorswasequalsignalintensityinT1WI，equalorhighsignalintensityinT2WI，andevenorunevenenhancementafterGd-DTPAinjection.MRIfindingsincludedinvasionofthesellaturcicaandadjacentbones，involvementofspheno

5、idsinusandcavern-oussinus，encasementofinternalcarotidartery.Tenpatientswithgrade-0invasiononMRIwerefoundtohavenon-involvementofcavernoussinusduringsurgery;14caseswithgrade-1invasiononMRI，threeofthemshowedinvolvementofcavernoussinusandencasementofinternalcarotidartery;in20casesw

6、ithgrade-2involvementofcavernoussinusonMRI，15wereconfirmedbysur-gery;inninecaseswithgrade-3invasiononMRI，eightwerefoundtohaveinvasionofcavernoussinusandlateralinterspaceofin-ternalcarotidartery;infivewithgrade-4invasiononMRI，fourhadinvolvementofcavernousandencasementofinternalc

7、arotidartery.ConclusionMRIishelpfulinprovidinginformationon8invasionofpituitaryneoplasmsforpreoperativediagnosis，whichisofgreatinstructionsignificanceforthemanagementofthedisease.　　［KEYWORDS］pituitaryneoplasms;magneticresonanceimaging;diagnosis　　垂体腺瘤（简称垂体瘤）是人类最常见的颅内肿瘤之一，约占颅内肿瘤的

8、10%～15%［1］。垂体瘤在组织学上属于良性肿瘤，但有些垂体瘤呈侵袭性生长，包绕或侵犯周围组织结构，该部分