动态MRI检查在Cushing病的临床应用价值

目的 为分析动态：MRI检查对普通MRI检查未发现垂体瘤的Cushing病(库欣病)的诊断价值。方法 回顾性分析7例普通：MRI检查未发现垂体微腺瘤的Cushing病人进行动态：MRI检查的结果，以及比较术中所见。7例均为女性，平均年龄33．5岁，平均病程2．7年，有典型的Cushing综合征的表现。结果动态MRI检查7例中，4例显示垂体微腺瘤，并经手术证实；3例未显示垂体腺瘤，但手术证实2例为垂体微腺瘤，1例为垂体细胞增生。随诊1—6个月，皮质醇降至正常6例。结论 对于临床症状和内分泌学检查符合Cushing病，而普通MRI检查未发现垂体腺瘤的病例，采用动态MRI检查能提高垂体ACTH微腺瘤的发现率。

Radiological Diagnosis of Cushing Disease by Dynamic MRI

Objective To analyze the radiological diagnosis of Cushing disease, in which pituitary microadenoma was not detected by conventional MRI, by dynamic MRI. Methods The radiological data of dynamic MRI in 7 patients with Cushing disease in which pituitary microadenomas were not detected by conventional MRI were analyzed retrospectively. The results of dynamic MRI were compared with the lesion which was observed during the operation. Seven patients with the mean age of 33.5 years all were female and had mean history of 2.7 years. All the patients had typical Cushing syndrome. Results Microadenoma was detected by dynamic MRI and confirmed by the transsphenoidal surgery in 4 patients. In remaining 3 patients with negative finding of dynamic MRI, microadenomas were found in 2 and pituitary hyperplasia in 1 during the operation. The level of plasma cortisol decreaced to normal in 6 patients during follow up from 1 to 6 months. Conclusion If clinical data and endocrinal examination accorded with Cushing disease but standard MRI scans showed no pituitary adenoma, dynamic MRI can improve the detection rate of pituitary microadnomas.