Rathke囊肿的MRI诊断与鉴别诊断

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1、Rathke囊肿的MRI诊断与鉴别诊断【摘要】目的：分析Rathke囊肿的MRI表现，提高Rathke囊肿的MRI诊断和鉴别诊断水平。方法：搜集经临床随访和手术病理诊断的12例Rathke囊肿患者的临床和MRI资料,所有病例均行MRI平扫,其中11例同时进行MRI增强扫描，分析囊肿的具体位置、大小、形态、边缘和MRI表现。结果：12例Rathke囊肿最大径均小于10mm,位于鞍内10例，位于鞍上2例。囊肿边缘光滑锐利，11例形态规则，1例呈分叶状。MRI平扫上T1WI和T2WI呈多种不同信号组合,其中6例T1WI呈低信号和T2WI呈高信号，11例增强扫描后呈环形强化

2、1例，未见强化10例。12例均未见囊内结节或囊底沉淀物征象。结论：鞍内Rathke囊肿的MRI表现较具有诊断特征，鞍上型Rathke囊肿较少见且常需要与鞍区其他囊性病变鉴别。【关键词】Rathke囊肿；MRI；诊断；鉴别诊断[Abstract]Objective：ToanalyzetheMRIfindingsofRathke'scleftcystandtoimprovethelevelofMRIdiagnosisanddifferentialdiagnosisinrathke?scleft・Method：TheclinicalandMRTdataof12patien

3、tswithRathkeJscleftcystprovedbyclinicalfollow-upandsurgicalpathologywerecollected.AllpatientsreceivedMRIplainscanningand11patientsreceivedcontrast一enhancedscanningatthesametime.Thelocation,size,shape,marginandMRTfindingsofRathke'scleftcystwereanalyzed.Result：Themaxima1diameterofthe12Ta

4、thke'scleftcystswaslessthan10mm.Therewere10cystsintheintrasellaand2cystsinthesuprasellar.Themarginsofallcystswereclear.11cystswereregularinshapeand1cystwaslobular・TherewerediversesignalsonT1WIandT2WI.ThelowsignalonT1WIandhighsignalonT2WIwereseenin6Rathke'scleftcysts.Afterenhancementsca

5、nin11patients,only1cystwasenhancedperipherallyandtheother10cystswerenotenhanced.TheintracysticnoduleandbottomsedimentdidnotappearinallRathke?scleftcysts.Conclusion：TheMRIappearaneeofintrasellarRathke'scleftcystsismorecharacteristicindiagnosis・However,thesuprasellarRathke'scleftcystisse

6、ldomseen,itoftenneedsdifferentialdiagnosisfromtheothercystic1esionsinthesei1arregion.【Keywords]Rathke'scleftcyst；MRI；Diagnosis；DifferentialdiagnosisFirst-author,saddress：YantianDistrictPeople'sHospitalofShenzhenCity,Shenzhen518081,Chinadoi:10.3969/j.issn.1674-4985.2015.32.024Rathke囊肿是一

7、种发生于鞍区的良性上皮性囊肿，又称垂体囊肿、上皮样囊肿和垂体胶样囊肿等，在临床和影像学表现上有时与鞍区蛛网膜囊肿、垂体瘤卒中、囊性颅咽管瘤和空蝶鞍等英他囊性病变相似而出现误诊,常需要进行鉴别诊断[1-5]o目前国内不同文献报道中Rathke囊肿MRT表现的病例样本大小不一，英MRI信号也表现多样。本文搜集12例Rathke囊肿的临床和MRI资料加以分析，结合文献复习以提高Rathke囊肿的MRI诊断与鉴别诊断水平，现报道如下。1资料与方法1.1一般资料搜集经临床随访和手术病理诊断的12例Rathke囊肿患者的临床和MRI资料，其中男5例，女7例，年龄9〜80岁，