鞍区Rathke囊肿MRI诊断

目的:探讨鞍区Rathke囊肿的MRI表现,以提高对该病的认识。方法:回顾性分析11例经手术病理证实的鞍区Rathke囊肿MRI表现。结果:囊肿位于鞍内4例,鞍内向鞍上延伸6例,完全位于鞍上1例,多呈圆形、卵圆形或哑铃形,边界清楚,囊壁菲薄。T1WI、T2WI示囊液均为高信号2例;T1WI上呈高信号、T2WI上呈低信号2例;其余7例,T1WI呈等信号2例,呈低信号5例,T2WI均为高信号。囊内可见漂浮结节影5例,囊壁见线样增强1例。结论:典型鞍区Rathke囊肿MRI表现有一定特征性,结合临床表现,术前正确诊断是可能,但不典型病例需与鞍区垂体腺瘤、颅咽管瘤相鉴别。     

鞍区Rathke囊肿的MRI表现

目的总结垂体Rathke囊肿的MRI表现,以提高对该病的认识。方法回顾性分析26例经手术和病理证实的Rathke囊肿的MRI表现。结果 26例Rathke囊肿多呈圆形或卵圆形,边界清楚,10例位于鞍内,16例位于鞍内和鞍上。10例T1WI呈低信号,T2WI呈高信号,6例T1WI呈等信号,T2WI呈高信号,9例T1WI和T2WI均呈高信号,1例T1WI和T2WI均呈等信号,其中5例T2WI上囊内显示类圆形低信号结节,16例行增强扫描,仅4例囊肿边缘出现轻度增强。结论垂体Rathke囊肿表现为鞍区的囊性占位,仔细分析其MRI表现,有助于术前对本病做出正确诊断。     

颅内表皮样囊肿的非典型CT和MRI表现

目的 探讨颅内表皮样囊肿的非典型CT和MRI表现,提高对本病的认识.方法 收集经手术病理证实的8例表皮样囊肿,术前均行MRI平扫,其中2例行扩散加权成像(difussion weighted imaging,DWI)检查,CT检查5例.MRI增强扫描4例.结果 8例表皮样囊肿发生于桥小脑角2例,大脑纵裂2例,脑实质2例,颅骨2例.CT显示囊肿表现为均匀高密度2例;混杂密度1例;囊壁及囊内钙化2例.MRI平扫2例T1WI呈均匀高信号,T2WI呈稍高、高信号;3例T1WI和T2WI呈混杂信号;3例T1WI呈不均匀低信号,T2WI呈高信号;其中1例DWI表现为高信号.4例MRI增强扫描显示囊壁显著环形强化和囊内不均匀强化2例,囊壁轻度强化2例.结论 颅内表皮样囊肿的CT和MRI非典型表现主要包括CT呈高密度、混杂密度、囊壁和囊内钙化,MRI T1 WI、T2WI呈高信号、混杂信号,增强扫描显著环形强化,在诊断时应充分结合DWI检查,以提高术前诊断准确性.     

Rathke囊肿的CT、MRI表现与手术病理对比

目的 分析Rathke囊肿的CT和MRI表现,提高对该病的诊断水平.方法 回顾性分析23例Rathke囊肿的CT及MRI资料,并与手术病理结果对比分析.结果 23例Rathke囊肿,CT平扫15例,其中4例为低密度,4例等密度,7例高密度,囊壁均无钙化.23例MRI平扫显示病变呈圆形或类圆形,4例位于鞍内,19例位于鞍内累及鞍上.4例呈长T1长T2信号,9例呈等T1等T2信号,5例呈等T1长T2信号, 1例呈等、稍长T1长、稍长T2信号,2例呈短T1长T2信号,1例呈短T1短T2信号.22例MRI增强扫描,病变均未见强化.结论 Rathke 囊肿密度/信号变化多样与囊液成分有关,病变均未见强化.     

鞍区Rathke＇s囊肿的影像学与组织学相关性研究

目的研究鞍区Rathke’s囊肿影像学与组织学的相关性，提高对其影像学诊断的准确性。资料与方法搜集29例经病理证实的Rathke’s囊肿，分析Rathke’s囊肿的囊液性质和囊壁组织成分与影像学的关系。结果多数Rathke’s囊肿在X线平片显示无蝶鞍扩大，这在影像诊断中有助于同囊性垂体腺瘤相区别。9例囊肿在MR T1WI显示高信号，组织学证实在囊壁上存在含铁血黄素和胆固醇。结论典型的Rathke’s囊肿MR T1WI显示为低信号，非典型Rathke’s囊肿MR T1WI呈高信号。出现高信号的原因可能为Rathke’s囊肿内的反复出血和胆固醇结晶沉积。     

鞍区Rathke囊肿的MRI表现

目的 总结垂体Rathke囊肿的MRI表现，以提高对该病的认识。方法回顾性分析17例经手术和病理证实的Rathke囊肿的MRI表现。结果 17例Rathke囊肿多呈圆形或类圆形，边界清楚，10例位于鞍内，7例位于鞍内和鞍上。MR信号在T1WI和T2WI上表现为：7例长T1、长T2，6例短T1、长T2，2例等T1、等T2，1例等T1、长T2，1例短T1、短T2。6例行增强扫描，3例无增强，3例囊肿边缘增强。结论 垂体Rathke囊肿表现为鞍内或鞍内和鞍上的囊性占位，MRI信号多样，但结合MRI形态、临床表现和其他影像学表现可作出正确诊断。     

鞍区囊性病变的MRI影像学表现

目的：探讨鞍区囊性病变的MRI影像学表现,以提高对此类病变的诊断水平。方法：37例鞍区囊性病变包括垂体腺瘤囊变16例、囊性颅咽管瘤5例、Rathke＇s囊肿5例、表皮样囊肿3例、蛛网膜囊肿5例、垂体脓肿3例。所有病例均行MRI平扫,其中32例行增强扫描。结果：鞍区病变以垂体瘤囊变最常见,主要表现为T1WI低信号,T2WI高信号,囊壁强化;颅咽管瘤、Rathke＇s囊肿信号较复杂,与囊内容物有关;蛛网膜囊肿、表皮样囊肿显示为与脑脊液信号;垂体脓肿增强扫描囊壁呈明显环形强化。结论：鞍区不同囊性病变具有一定MRI表现特点,结合临床病史多数病变可做出正确诊断。     

颅骨表皮样囊肿的影像学表现及文献回顾

目的 探讨颅骨表皮样囊肿CT及MRI表现特点.方法 回顾性分析7例经手术证实的颅骨表皮样囊肿的CT及MRI表现,3例行CT及MRI平扫,其中2例行MRI增强扫描,4例只行CT扫描.结果 病变发生于枕骨4例,顶骨2例,颞骨1例.7例CT表现为颅骨膨胀性骨质破坏,类圆形或分叶状,边缘锐利,周围见断续钙化边或硬化带,病变中心呈混杂密度,3例病灶内可见死骨样高密度影.MRI表现为T1WI混杂低信号,T2WI混杂高信号,脂肪抑制序列呈高信号,增强扫描病变较小者无明显强化,病变较大者周围见淡薄线样强化,囊内容物无强化.当囊内容物中以蛋白、胆固醇结晶为主、轻微钙化时,CT表现为混杂密度,其内可出现高密度影,对应的MR T1WI呈等或高信号,T2WI为低或等信号.手术显示病变相邻脑实质均未受累.结论 CT与MRI结合对术前诊断颅骨表皮样囊肿很有价值.     

不典型Rathke裂囊肿的MRI诊断

目的:探讨不典型Rathke裂囊肿的MRI特征性表现及鉴别诊断.方法:回顾性分析经病理证实的Rathke裂囊肿28例,其中18例影像学表现不典型,总结其部位、信号、囊壁、胶样小体及强化方式的的诊断价值.结果:11例病变位于鞍内,17例位于鞍内及鞍上,呈圆形或类圆形,边界清楚;囊内容物信号表现多样,其中等T1长T2信号3例,短T1长T2信号7例,短T1短T2信号5例,短T1等T2信号1例,混杂T1、T2信号2例;囊内可见漂浮结节者6例;垂体窝内可见受压的正常垂体组织者16例.增强MRI:4例无强化,10例可见囊壁周围区域呈断续的线样强化.结论tMRI平扫能够清楚显示病变,但对于不典型Rathke裂囊肿的的诊断有一定的局限性;增强MIU有利于同鞍区其它病变的鉴别诊断.     

骶前间隙表皮样囊肿MRI表现特征

目的 探讨骶前间隙表皮样囊肿的MRI表现特征.方法 回顾性分析4例经手术和病理证实的骶前表皮样囊肿的MRI表现,并对国内外相关文献复习.结果 4例均位于骶前间隙,呈囊性病变,囊壁薄而均匀,囊液呈T1WI均质或不均质低信号,T2WI不均质高信号,囊内可见云絮状或结节状角化物,呈T1WI等信号,T2WI低信号.结论 骶前表皮样囊肿的MRI影像学表现具有特异性.     

鞍区Rathke裂囊肿的影像诊断

目的:研究鞍区Rathke裂囊肿的CT及MRI的表现特点。方法:回顾性分析21例经手术病理证实的Rathke裂囊肿的CT和MRI表现。结果:囊肿多位于鞍内,呈圆形或类圆形,边界清楚。病变大小为0.5~3.2cm,平均1.35cm。CT多为低密度,MRI信号表现根据囊液成分的不同变化多样。囊内可见漂浮结节4例。增强扫描一般无增强。结论:CT和MRI对鞍区Rathke裂囊肿的诊断有一定的价值,但应注意与垂体瘤和颅咽管瘤相鉴别。     

Rathke囊肿:CT、MRI表现与病理对照研究

目的：探讨Rathke囊肿的影像学表现与病理组织学之间的关系。材料和方法：病理证实的Rathke囊肿20例，男12例，女8例。年龄11—70岁，平均44岁。18例行CT检查，其中7例增强；12例行MRI检查，其中7例增强；20例中CT和MRI检查均进行有10例。分析所有CT、MRI片，并与手术病理对照。结果：10例Rathke囊肿位于鞍内，9例位于鞍内伴鞍上延伸，1例位于鞍上。Rathke囊肿因其囊液成分不同而有不同的影像学表现。少数伴出血。一般无强化，少数可见囊壁的强化。结论：Rathke囊肿影像学表现多样，CT和MRI有一定的价值，确诊需结合病理分析。     

Rathke囊肿的CT和MRI诊断

目的:分析Rathke囊肿之CT及MRI表现.材料和方法:回顾性分析7例(男3例,女4例,平均年龄32.4岁)经手术病理证实的Rathke囊肿的CT及MRI表现.结果:7例Rathke囊肿中,单纯位于鞍内者3例,直径均小于1.2cm;鞍内鞍上者4例,直径均大于1.2cm.CT及MRI表现根据囊液成分的不同变化多样,增强扫描一般无增强,囊壁极少钙化.结论:垂体Rathke囊肿术前较难明确诊断,仔细分析其CT及MRI表现,有助于提高本病的正确诊断率.     

Rathke囊肿的影像诊断及误诊分析

目的研究Rathke囊肿的影像学表现。资料与方法回顾性分析经病理证实的13例Rathke囊肿的CT和MRI表现。结果 13例病变均同时位于鞍内及鞍上。5例诊断正确;5例误诊为垂体瘤;3例误诊为颅咽管瘤。结论 Rathke囊肿的CT和MRI表现具有一些特点:密度或信号多变但均匀、囊内结节、无强化或环状强化、较少钙化,为诊断提供有价值的鉴别依据。     

新生儿鳃裂囊肿的CT与MRI表现

目的 探讨新生儿鳃裂囊肿的CT与MRI表现及鉴别诊断. 资料与方法对13例经手术和病理证实的新生儿鳃裂囊肿的CT和MRI表现进行回顾性分析,并结合文献进行讨论.结果 13例均为第2鳃裂囊肿.根据Bailey分型,Ⅰ型4例,Ⅱ型9例.CT与MRI表现为颈侧部圆形或椭圆形,壁薄、均质的囊性肿块,胸锁乳突肌受压向后或后外移位,颈动脉鞘内大血管向内或内后移位,颌下腺向前移位,囊壁强化的厚度取决于感染的程度.结论 CT与MRI可定位、定性诊断鳃裂囊肿,其中"气-液征"是新生儿期鳃裂囊肿特有的征象.     

Displacement of the normal pituitary gland by sellar and juxtasellar tumours: surgical-MRI correlation and use in differential diagnosis

We compared the position of the normal pituitary gland as estimated by gadolinium (Gd)-DTPA-enhanced MRI, with its position at surgery in 40 patients with intra- and juxtasellar tumours: 22 pituitary adenomas, 4 craniopharyngiomas, 7 meningiomas, 2 germinomas, and 5 Rathke cleft cysts. In 37 of these, the normal gland showed more intense contrast enhancement than the adjacent tumour, from which it could be differentiated by Gd-DTPA-enhanced MRI, especially in the sagittal plane. The direction of displacement of the normal pituitary gland correlated well with tumour type, so that its position proved helpful in the differential diagnosis. The normal gland was typically displaced superiorly by pituitary adenomas, inferiorly by craniopharyngiomas, and anteriorly by germinomas. It showed variable displacement by Rathke cleft cysts, and was not usually displaced by meningiomas.     

Rathke cleft cysts: CT, MR imaging, and pathologic features

The authors retrospectively reviewed the clinical, computed tomography (CT), and magnetic resonance (MR) imaging findings in seven patients with pathologically proved Rathke cleft cysts. All the cysts were located in the anterior sella turcica or the anterior suprasellar cistern. Five cysts had both intra- and suprasellar components, one was entirely intrasellar, and the other was predominantly suprasellar in location. The size of the cysts ranged from 8 to 20 mm. CT scans demonstrated low-density homogeneous lesions in four cases. On MR images of three of these four cases, the cysts had the same intensity as cerebrospinal fluid on T1- and T2-weighted images, while in the fourth case, the cyst was hyperintense on the T1-weighted images. In the remaining three cases, CT showed slight hyperdensity relative to brain parenchyma, suggestive of contrast enhancement. MR showed signal heterogeneity of these lesions with focal components of diminished signal intensity of T2-weighted images. These same foci appeared iso- to slightly hyperintense on T1-weighted images.     

鳃裂囊肿的MRI和CT诊断

目的：讨论鳃裂囊肿的ＭＲ和ＣＴ表现及其诊断价值。方法：对均经手术和病理证实的１１例鳃裂囊肿病人（第一鳃裂囊肿２例,第二鳃裂囊肿９例）的ＣＴ或ＭＲＩ的表现进行分析,并结合文献进行讨论。结果：第一鳃裂囊肿表现为耳前区反复感染或瘘,其特征为瘘道与外耳道平行;第二鳃裂囊肿常表现为颈外侧部和颌下区无压痛囊性肿块,ＣＴ和ＭＲＩ表现为薄壁、均质的囊性肿块,胸锁乳突肌受压向后外或向后移位,颈动脉间隙大血管向内或向     

Computed tomography in intra- and suprasellar epithelial cysts (symptomatic Rathke cleft cysts)

The computed tomographic (CT) and pathologic findings in three cases of intra- and suprasellar epithelial cysts (symptomatic Rathke cleft cysts) are described. Literature review revealed that the characteristic CT finding is an intrasellar and/or suprasellar low-density mass that may or may not be enhanced. The enhancement is ringlike or capsular in nature. Whether the cyst wall is enhanced or not seems to be dependent on the histologic features. It is suggested that the enhancement may be caused by an inflammatory process, either septic or aseptic, or squamous metaplasia in the wall, which is possibly induced by degeneration or infection of the cyst contents. Without these additional pathologic processes, the Rathke cleft cyst, a simple retention cyst, may exhibit no contrast enhancement.     

Pituitary adenoma, craniopharyngioma, and Rathke cleft cyst involving both intrasellar and suprasellar regions: differentiation using MRI

AIMS: To determine the differential magnetic resonance imaging (MRI) features of pituitary adenoma, craniopharyngioma, and Rathke cleft cyst involving both intrasellar and suprasellar regions. MATERIALS AND METHODS: The MRI images of 64 patients with pituitary adenoma (n=38), craniopharyngioma (n=13), or Rathke cleft cyst (n=13) were retrospectively reviewed by three neuroradiologists. The following characteristics were evaluated: shape, volume, extent, component characteristics, signal intensities of solid portions on T2-weighted images, signal intensities of cystic portions on T1-weighted images, and enhancement patterns of solid portions and cyst walls of tumours. Fisher's exact test applied with Bonferroni correction was used for multiple comparison. A flowchart for differential diagnosis was constructed based on statistical analysis of the results. RESULTS: A snowman shape, solid characteristics, and homogeneous enhancement of the solid portion were more common in pituitary adenomas (p<0.017). A superiorly lobulated shape, third ventricle compression by superior tumour extension, mixed solid and cystic characteristics, and reticular enhancement of the solid portion were more common in craniopharyngiomas (p<0.017). Finally, an ovoid shape, a small tumour volume, cystic characteristics, and no or thin cyst wall enhancement were more common in Rathke cleft cysts (p<0.017). The flowchart yielded diagnostic accuracies as follows: 92.1% in pituitary adenoma; 92.3% in craniopharyngioma; 92.3% in Rathke cleft cyst; and 92.2% overall. CONCLUSION: A combination of MRI findings is helpful in the differential diagnosis of the three tumours involving both intrasellar and suprasellar regions.