垂体柄阻断综合征的临床及MRI表现

目的:分析垂体柄阻断综合征(PSIS)的MRI表现,以提高诊断水平。方法:回顾性分析16例PSIS患者的临床和MRI检查资料。结果:16例患者实验室检查示单或多种垂体激素缺乏,具备相应临床症状。MRI检查显示垂体前叶均变小,15例患者垂体柄未显示,1例垂体柄中断,15例垂体后叶异位,1例后叶高信号未见显示。结论:PSIS表现为部分性或完全性垂体前叶功能减退,MRI特点为垂体体积缩小、垂体柄中断或缺如、垂体后叶异位三联征。     

垂体柄阻断综合症的HRI诊断与临床特点分析

目的分析总结垂体柄阻断综合症（PSIS）的临床特点与MRI表现,提高对该病的认识和诊断水平。方法回顾性分析5例诊断为垂体柄阻断综合症的临床特点与MRI表现。结果MRI显示垂体柄缺如4例,垂体柄明显变细1例,垂体后叶异位5例,垂体前叶变小5例。5例患者均表现生长发育迟缓,胰岛素低血糖兴奋试验提示生长激素缺乏,伴多种腺垂体激素缺乏。结论垂体MRI是诊断本病最重要和最直接的检查,PSTS具有特征性MRI表现,结合,临床表现和实验室检查可做出准确诊断。     

神经垂体肿瘤临床影像诊断分析

目的 探讨和了解神经垂体肿瘤的影像学表现、组织学发生及其个性化治疗.方法 对11例神经垂体肿瘤影像学表现和临床资料进行回顾性分析.结果 神经垂体肿瘤多表现为局限于垂体后叶及垂体柄的微小病变,极少累及垂体前叶,偶可沿垂体柄向鞍上生长,形成较大的占位性病灶.MRI表现:T1W呈混杂信号,T2W呈稍高或混杂信号.注射Gd-DTPA后病灶可被强化,但信号略低于周围正常的垂体组织,两者可以藉此分辨.组织学检查:垂体颗粒细胞肿瘤GFAP染色弱阳性,胞质内富含各种小囊泡和各级溶酶体颗粒,偶见有不等量的中间微丝.垂体噬酸性颗粒细胞腺瘤FSH、TSH、LH染色弱阳性,胞质内的颗粒成份为密集肿胀变形的线粒体.结论 神经垂体肿瘤包括沿垂体柄向上移行生长的垂体腺瘤和原发于神经垂体部位的肿瘤.颗粒细胞肿瘤可能是胶质细胞来源的肿瘤,多局限于垂体后叶和垂体柄.神经垂体肿瘤的MRI特征性表现有助于临床诊断.经鼻经蝶入路手术和立体定向放射外科治疗是目前较理想的治疗方法.     

垂体柄阻断综合征的MRI诊断价值

目的分析垂体柄阻断综合征的MRI影像表现,提高对其的认识及诊断水平。方法回顾性分析7例垂体柄阻断综合征患者的影像学及临床资料。结果 7例生长发育迟缓患者中MRI均未见垂体柄显示,垂体窝内垂体后叶高信号均消失,腺垂体体积变小,神经垂体异位于视交叉漏斗隐窝。结论垂体柄阻断综合征在MRI具有特征性表现,是无创诊断垂体柄阻断综合征的最佳方法。     

鞍区囊性病变影像学诊断

目的:探讨鞍区囊性病变的CT和MR I表现,提高对该类疾病的诊断和鉴别诊断水平。方法:收集经手术病理与临床证实的鞍区囊性病变的CT和/或MR I资料72例,其中囊性垂体瘤12例,囊性颅咽管瘤25例,Rathke囊肿16例,蛛网膜囊肿4例,鞍上池下疝继发假性蛛网膜囊肿4例,鞍旁表皮样囊肿4例,鞍旁皮样囊肿3例,垂体脓肿4例。全部病例均行CT和/或MR I平扫,其中14例行CT增强检查,58例行MR I增强检查。72例中65例经手术病理证实,7例经临床证实。结果:12例囊性垂体瘤,其中垂体大腺瘤8例,微腺瘤4例。6例大腺瘤表现为在实性瘤体内出现囊变区,2例瘤卒中囊变区内可见液平。4例囊性垂体微腺瘤显示垂体饱满,内部出现异常信号/密度,伴有化验室检查异常。25例囊性颅咽管瘤以囊性表现为主,发现囊壁钙化及强化的垂体对鉴别诊断有意义。16例Rathke囊肿信号多样,但以形态饱满,呈短T1、长T2信号为较具特征性的改变。4例蛛网膜囊肿和鞍上池下疝继发假性蛛网膜囊肿均表现为脑脊液信号,而后者囊壁出现连续或不连续薄壁环形强化,为其特征性表现。3例皮样囊肿密度/信号较表皮样囊肿复杂,压脂序列对两者鉴别诊断有帮助。4例垂体脓肿增强均显示环形强化,结合临床病史有助于术前诊断。结论:鞍区不同性质的囊性病变具有一定的影像学特点,通过详细的影像学检查可对其中多数病变做出正确的定性诊断。     

垂体柄阻断综合征的MRI特征及相关临床分析

目的:分析垂体柄阻断综合征(PSIS)临床表现、实验室检查及特征性MRI的影像改变,提高本病的早期诊断。方法:回顾性分析我院15例PSIS患者的临床表现、实验室检查及MRI影像学特点,结合文献分析其表现。结果:MRI可直接显示垂体后叶异位,多高位于下丘脑漏斗处,垂体柄缺如,垂体前叶低伏于垂体窝底;实验室检查均有生长激素和(或)其他激素的缺乏。结论:MRI检查是垂体柄阻断综合征诊断的解剖学依据,结合其临床表现、实验室检查,可以早期对本病作出正确诊断。     

正常垂体CT表现

研究90例正常人垂体CT所见,其结果为:①垂体高度随年龄增长而逐渐变小,与年龄呈负相关;②垂体上缘凹者24.5%,平直形63.3%,凸形12.2%,其上缘凹者随年龄增长逐渐增多,凸者随年龄增长而减少;③垂体蒂位置居中;④垂体密度均质者44.4%,非均质者55.6%;⑤垂体后叶可呈卵圆形低密度区;⑥鞍底平直形54.5%,凸形10%,凹者35.5%,鞍底骨质局限性吸收变薄者14.4%。     

MAGNETIC RESONANCE IMAGES OF THE HYPOTHALAMIC-PITUITARY AREA IN IDIOPATHIC GROWTH DEFICIENCY

In order to describe the magnetic resonance imaging (MRI) findings in hypothalamic-pituitary area and its clinical relevance in patients with idiopathic growth hormone deficiency (IGHD), the MR imagings of 26 patients with IGHD were analyzed. On MRI, 24 out of 26 cases (92. 3%) showed apparent pituitary upper margin depression; 8 out of 26 cases (30. 8%) showed definite pituitary stalk transection; 22 out of 26 cases (84. 6%) showed absence of the normal posterior pituitary bright spot. The bright lipidlike signal on T1W1 images at the median eminence distal to the breaking point (so-called ectopic posterior lobe) was found in 4 out of 26 cases (15. 4%). According to the MRI findings of the pituitary stalks, the 26 cases were divided into three groups; group A of 8 cases (31%) characterized by the definite transaction of stalk; group B of 13 cases (50%) defined by the possible stalk transection; and group C of 5 cases (19%) with no definite stalk transection.MRI findings were consistent with the clinica     

垂体柄与垂体腺瘤显微解剖关系的临床观察

目的 观察垂体柄与肿瘤的解剖关系。以利术中保护垂体柄免受损伤。方法 在鞍膈平面,以鞍结节与鞍背两者中点的连线为标准,判断垂体柄的侧别位置,再将鞍膈平面视做时钟面板,进而判断垂体柄 的时钟位。结果 71例观察中,垂体柄居左侧17例,右侧41例,后中位13例。其中46例以时钟位判断,5时位13例,6时位11例,7时位7例,4时位5例,3时位4例,2、8及11时钟位各为2例。结论 垂体柄的位置与肿瘤在鞍内的生长方向有关,与向鞍上扩展无关,垂体柄可作为寻找正常垂体组织的标志。     

Cerebral Histiocytosis-X with Endocrine Symptoms

A neuropathologically verified case of histiocytosis-X in a 21-year-old man with endocrine symptoms is presented. The granulomas were confined to the central nervous system and occupied mainly the pituitary stalk and hypothalamus, thus giving us the opportunity to observe the endocrine symptoms caused by such localized lesions.

Diabetes insipidus was one cardinal endocrine symptom and is considered to be caused by a hypothalamic lesion in the supraoptic nuclei or the pathways to the posterior pituitary. In this case the anterior pituitary was not involved by granulomas, but the posterior lobe was atrophic.

Severe hypogonadism and probably also a growth hormone defect were present, probably resulting from pituitary insufficiency secondary to the hypothalamic lesions.

Hypothyroidism was another symptom but in this case was probably due to thyroiditis. Such a finding has previously been observed by two other authors and may therefore be pathologically connected to histiocytosis-X even though no granulomas were present in the thyroid gland.

Repeated X-ray investigations from 9 years of age showed that the development of the sella turcica ceased about the same time as the patient got signs of diabetes insipidus. Increase in sellar volume normally reflects pituitary growth. The lesions in the pituitary stalk or the hypothalamus must therefore have been present from the time when diabetes insipidus started.