脑垂体解剖及病变.doc

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1、TheRadiologyAssistantHomeAbdomenBreastCardiovascularChestHeadNeckMusculoskeletalPediatricsNeuroradiologyMiscellaneousCasesTopSitesNewsletterSellaTurcicaandParasellarRegionbyWalterKucharczykandMariekeHazewinkelRadiologydepartmentoftheUniversityofToronto,CanadaandtheR

2、adiologydepartmenttheMedicalCentreAlkmaar,theNetherlands·AnatomicApproachtoDifferentialDiagnosis·PituitaryMicroadenoma·PituitaryMacroadenoma·RathkeCleftCyst·Craniopharyngioma·Meningioma·Aneurysm·AneurysmvsMeningioma·Hamartoma·HypothalamicandChiasmGlioma·Germinoma·Ch

3、ordoma·Metastasesbacktooverview   printPublicationdate:10-8-2008ThisreviewisbasedonapresentationgivenbyWalterKucharczykaandwasadaptedfortheRadiologyAssistantbyMariekeHazewinkel.Inthisreviewasystematicanatomicapproachtodifferentialdiagnosisofasellarorparasellarmassis

4、described.Byclickingononeofthesubjectsinthelistontheleft,youwillgodirectlytothisitem.Ifyouhaveprintingproblemswiththemarginsofthedocument,youmayhavetoadjustthemarginsinthepagesetupofyourinternetbrowser,whichyouwillfindinthetopleftofthemenubar. AnatomicApproachtoDiff

5、erentialDiagnosisInordertoanalyzeasellarorparasellarmassonMRIweusethefollowinganatomicapproach:1.Firstidentifythepituitaryglandandsellaturcica.2.Thendeterminetheepicenterofthelesionandwhetheritisinthesellaorabove,beloworlateraltothesella.3.Ifitisinthesella,determine

6、whetherornotthesellaisenlarged.4.Oncethelocationofthemassisclear,analyzethesignalintensitypatterns:isthelesioncysticorsolid?5.Doesitcontainanyabnormalvessels?6.Arethereanycalcifications?Andsoon.7.FinallyestablishaDifferentialDiagnosis.PituitaryglandOnacoronalsection

7、throughthebrainthereferencestructureisthepituitaryglandwhichliesinthesellaturcica.Itisusuallylargerinfemalesthaninmales-infemalesthesuperiorbordertendstobeconvex,whereasinmalesitisusuallyconcave.Themostcommonabnormalitiesthatariseinthepituitaryglandarepituitaryadeno

8、ma,Rathke'scleftcystandcraniopharyngioma.PituitarystalkThenextstructuretoidentifyisthepituitarystalk.Thisisaverticallyorientedstructurewhi