空蝶鞍综合征一附MRI诊断40例分析

本文对ＭＲ诊断的４０例空泡蝶鞍临床表现及影像改变进行分析，结合文献对其发病机理、临床特点进行探讨，提出本征与先天鞍隔缺损、脑脊液压力增高、垂体肥大继之萎缩有关，多为女性，中年肥胖者。ＭＲ特征为：垂体压扁至鞍底，冠状位呈“锚”形，鞍内充满脑脊液。     

空蝶鞍综合征—附MRI诊断40例分析

本文对ＭＲ诊断的４０例空泡蝶鞍临床表现及影像改变进行分析，结合文献对其发病机理，临床特点进行探讨，提出本征与先天鞍隔缺损，脑脊液压力增高，垂体肥大继之萎缩有关，多为女性，中年肥胖者。ＭＲ特征为：垂体压扁至鞍底，冠状位呈“锚”形，鞍内充满脑脊液。     

空蝶鞍综合征的MRI诊断分析

目的：探讨ＭＲＩ对本病的诊断价值。方法：分析２５例空蝶鞍的临床及ＭＲＩ表现，并对发病机理进行探讨。结果：空蝶鞍的ＭＲＩ征象有（１）鞍内为脑脊液充填；（２）蝶鞍增大；（３）垂体受压紧贴鞍底，矢状位呈弧线样，冠状位呈“锚”状；（４）垂体柄居中、延长；（５）可伴有脑积水等脑脊液压力增高病变。结论：空蝶鞍有相似的ＭＲＩ征象，ＭＲＩ多方位的特征性表现能作出正确诊断。     

原发性空泡蝶鞍综合征与头痛程度相关性的MRI研究

目的探讨原发性空泡蝶鞍综合征与头痛程度的关系。资料与方法对140例经临床证实为原发性空泡蝶鞍综合征患者的临床及MRI资料进行综合分析,计算其空蝶鞍分级,采用统计学方法分析其与头痛程度的关系。结果空蝶鞍分级与头痛程度之间差异无统计学意义(P>0.05)。结论空蝶鞍分级与头痛程度之间无明确关系,临床需密切结合其他检验指标综合判断患者病情。     

空蝶鞍综合征的MRI诊断

目的：探讨MRI对本病的诊断价值。方法：分析15例空蝶鞍的临床及MRI表现。结果：空蝶鞍的MRI征象有（1）鞍内为脑脊液信号；（2）垂体受压紧贴鞍底；（3）蝶鞍增大；（4）垂体柄居中。结论：空蝶鞍有相似的MRI征象，MRI多方位成像能作出正确诊断。     

空蝶鞍综合征的MRI诊断

空蝶鞍综合征（empty sella syndrome,ESS）又称蛛网膜隔疝,是指鞍上池蛛网膜下腔经鞍隔孔疝入鞍内压迫垂体及硬脑膜等,而出现的一系列症候群。在MRI问世之前,多认为此病少见,未能受到足够重视,随着MRI的广泛应用,此病有明显增多趋势,已逐渐引起临床医师重视。本文收集有完整资料、经MRI诊断的ESS23例,现分析报告如下。     

空蝶鞍综合征的MRI诊断与临床分析

空蝶鞍为鞍上蛛网膜经缺损的鞍隔疝入鞍内所致，空蝶鞍综合征可引起头痛、头晕、视力障碍、内分泌紊乱等一系列临床症状。在MRI应用之前认为此征少见，随着MRI的应用，有明显增多趋势。但文献报道不多，本文收集有完整资料的空蝶鞍综合征36例，就其发病机理、临床表现及MRI征象分析讨论如下。     

以骨折为首发诊断的空泡蝶鞍综合征1例

患者,女性,66岁。因“骨折2个月,意识不清8小时”于1998年5月5日入我院神内科。患者于入院前2个月不慎摔伤而致左侧股骨颈骨折,骨折愈合差。入院当日突发意识不清伴大小便失禁。查体：体温36．8℃,呼吸20次／分,脉搏70次份,血压18／11kPa。心律不齐,可闻及早搏,面色苍白,颜面略显浮肿。神经系统检查：意识不清呈浅昏迷状态,双侧瞳孔等大等圆,直径约0．3cm,光反射迟钝,双侧膝反射（＋）,生理征存在,病理征求引出。检查：K 2.89mmol／L,Na 118mmol／L,CL－82mmol／L;血糖3．0mmol／L,ECG提示：窦性心律,偶见房早入…     

空蝶鞍综合症的MRI诊断

目的：探讨空蝶鞍综合症的MRI诊断价值。方法：回顾性分析28例经临床证实的空蝶鞍综合症MRI资料。结果：空蝶鞍综合症MRI显示为蝶鞍扩大、垂体受压萎缩、垂体柄的拉长折曲;临床表现为颅内压增高、垂体前叶功能减退等症状。结论：空蝶鞍综合症的MRI诊断容易,临床指导价值较大。     

数字化成像小剂量定向气脑造影诊断空泡蝶鞍

本文介绍4例采用X线数字化成像小剂量定向气脑造影法诊断空蝶鞍，本方法可在实时数字成像电视监视下选择满意图像即时摄片．患者取座位完成检查全过程，且注入气量少从而明显方便操作，减轻患者痛苦。     

Pneumoencephalographic changes with intrasellar cisternal herniation (primary empty sella)

Summary In a selected material of 47 cases of primary intrasellar cisternal herniation, analysis of pneumoencephalographic changes demonstrated the long axis of the anterior part of the third ventricle to point towards the center of the herniation. Transmitted CSF pulsations from the third ventricle probably determine the formation and location of intrasellar herniations. The distribution of air in the subarachnoid space indicated a disturbed CSF circulation in the majority of patients. Visual field defects were unrelated to the slight deformity of the optic nerves observed but rather to a high position of the third ventricle.     

CSF circulation in subjects with the empty sella syndrome

Summary The etiology to the empty sella syndrome (ESS) is not known. Increased intracranial pressure (ICP) has been suggested to be one of the possible causes. In the present study the CSF circulation was analyzed in 48 subjects with ESS with gamma cisternography, pneumoencephalography (PEG) and computed tomography (CT). In 80% of the subjects the CSF circulation was retarded with convexity block which was combined with widened CSF transport pathways and basal cisterns. These findings were corelated with the clinical signs and symptoms, most of which seemed to be related to the impaired CSF circulation (i. e. impaired memory, balance disturbances, cerebellar ataxia, papilledema, hypertension and pituitary disorders). Headache, psychiatric symptoms, visual field defects and obesity, however, were not related to the impaired CSF circulation. It is concluded that impaired CSF dynamics leading to intermittent increase of ICP has a major impact on the development of the ESS and that most of the patients' complaints are related to this disturbance. Thus it is important to obtain information of the CSF dynamics concurrent with the diagnosis of ESS. For this purpose PEG or CT may be used as the first examination. Moreover, the patient should be examined at least every second year for symptoms and signs of progressive impairments of the CSF circulation.     

Flattened sella turcica and CT appearance of normal pituitary gland

Summary A flattened sella turcica, not previously reported, was found incidentally in a 21-year-old male. Various neuroradiological and hormonal examinations have proved it to be a normal varient. Subsequently a normal pituitary gland was shown by CT.     

CT Iopamidol cisternographic diagnosis of coexisting partial empty sella and pituitary adenoma

Summary In the last 3 years 86 patients were referred for suspected primary intrasellar pathology. Two of them had coexisting pituitary adenoma and partial empty sella. This situation has been diagnosed preoperatively thanks to CT Iopamidol cisternography. The pre-operative diagnosis of this common anatomic condition allows safer operations, preventing intra-operative CSF fistulas.     

Wegener's granulomatosis with unusual cavernous sinus and sella turcica extension

Intracerebral extension of Wegener's granulomatosis (WG) is rare. We present a patient with oculomotor and trochlear nerve palsy with histologically proved WG. An MR examination revealed granulomatous tissue in nasal cavity, paranasal sinuses with meningeal infiltration, and uncommon penetration into cavernous sinus and sella turcica. The MR images before and during pharmacological therapy are presented. Received: 14 July 1998; Revision received: 12 October 1998; Accepted: 13 January 1999     

The empty sella syndrome-intrasellar cisternal herniation-in “normal” patients and in patients with communicating hydrocephalus and intracranial tumors

Summary The occurrence of empty sella was studied on 450 pneumoencephalograms. It was not sex dependent, and seemed to be an acquired condition increasing in frequency with age. Empty sella was found in 10% of subjects with otherwise normal encephalograms. The frequency was higher in persons with communicating hydrocephalus (32%), hormoneproducing pituitary tumors (33%) and increased intracranial pressure due to cerebral tumors (18%). In all these subjects empty sella was often accompanied by demineralization and erosion of the sella turcica. Independent of the lumbar pressure, empty sella was most often found in patients with communicating hydrocephalus with only moderately high ventricle index and comparatively increased volume of the third ventricle. Empty sella was also frequent among patients with temporal tumors (32%) causing deformation and displacement of the third ventricle but in whom signs of increased intracranial pressure were lacking. The disturbed anatomy of the third ventricle possibly explains the higher frequency of empty sella in association with these tumors compared to other supratentorial tumors. altogether, these findings indicate that disturbance of the cerebrospinal fluid (CSF) circulation, especially in the third ventricle, with or without established increase of the intracranial pressure, plays an important role in the etiology of empty sella. This is further substantiated by the demonstration that the type of intrasellar herniation could be related to the position of the third ventricle. Neither the type of herniation nor the form of the sella could be related to the presence or absence of a co-existing intracranial tumor or to the location of the tumor.     

Value of petrosal sinus sampling: coexisting acromegaly,empty sella and meningioma

Simultaneous occurrence of an intracranial meningioma and a growth hormone (GH)-producing pituitary adenoma is exceedingly rare, as is coexistence of an empty sella and acromegaly. We report all these rare entities in the same patient. We evaluated the role of inferior petrosal sinus sampling for lateralisation of an adenoma in this patient.