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。     

中枢性尿崩症的MRI诊断

目的 通过垂体MRI观察中枢性尿崩症患者垂体后叶及垂体柄的改变。资料与方法 回顾性分析37例经临床和实验室证实的尿崩症患者的MRI资料，分析其临床与MRI表现。结果 37例中导致中枢性尿崩症的病因包括感染、肿瘤性病变、创伤及空蝶鞍。按其MRI表现分为3种类型：垂体柄病变；单纯垂体后叶高信号消失；空蝶鞍。结论 对于尿崩症的患者，结合临床表现，利用垂体MRI检查，可显示垂体后叶及垂体柄的改变，为临床诊断、治疗提供可靠依据。     

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。     

空泡蝶鞍综合征MRI诊断（附72例分析）

目的探讨MRI对本病的诊断价值。方法分析72例空泡蝶鞍综合征的临床表现及MRI表现,并对其病因,发病机理进行探讨。结果总结出空泡蝶鞍综合征的MRI征象有：(1）蝶鞍扩大;(2)鞍内被脑积液充填;(3)垂体受压变扁紧贴鞍底矢状位呈弧线样或新月彤;(4)垂体柄延长,伸向鞍底;(5)可伴有脑积水等脑脊液压力增高征象;(6)可伴有脑肿瘤,脑囊虫等脑脊液压力增高病变。结论MRI对空泡蝶鞍综合征的诊断准确可靠,是影像学的最佳检查手段。     

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。     

原发性垂体前叶功能低下症原因的MRI诊断

目的分析原发性垂体前叶功能低下症的MR影像特点,以明确其病因.材料与方法经临床,实验室及MR确诊的原发性垂体前叶功能低下症共21例.均行MR平扫及增强检查.结果垂体大腺瘤共9例(女3例,男6例),5例合并腺瘤出血.继发性空蝶鞍8例,均为女性,其中5例继发于微腺瘤术后,1例继发于腺瘤γ刀治疗后,2例继发于产后大出血.垂体低矮共3例(1例为儿童,2例为成年女性).垂体影像正常1例.结论原发性垂体前叶功能低下症的常见病是垂体大腺瘤和继发性空蝶鞍,MRI能为明确病因提供可靠的影像学证据.     

特发性颅内高压的影像学研究

目的研究特发性颅内高压（IIH）的可靠影像学征象及与临床症状的关系,提高对该病的认识。方法研究2008年7月～2012年12月有完整临床、影像学资料的20例IIH患者,并以同期20例正常志愿者作为对照组。由2位有经验的神经放射医生共同评价影像学异常,包括垂体及蝶鞍形态、脑室形态及视神经鞘形态。结果空蝶鞍/部分空蝶鞍和视神经鞘扩张都具有较高的敏感性（分别为75％、80％和75％）和特异性（分别为95％、75％和80％）;2组之间Evans指数、双侧麦氏腔长宽比及OND均无统计学差异（P〉O．05）,垂体腺高度及深度、双侧ONSD均有统计学显著性差异（Pd0．01）。结论空蝶鞍和视神经鞘扩张是IIH的可靠影像学征象。正确认识IIH的影像学表现对其早期诊断和治疗具有重要价值。     

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。     

鞍结节脑膜瘤与向前上生长的垂体腺瘤MRI鉴别诊断

目的 探讨鞍结节脑膜瘤与向前上生长的垂体大腺瘤的影像学鉴别要点。资料与方法 分析17例经手术证实的鞍结节脑膜瘤的MRI征象,并与同期病理确诊的14例垂体大腺瘤进行对照。结果 17例脑膜瘤：均显著强化,包绕颈内动脉13例,长脑膜尾征14例、瘤周较多流空信号5例,蝶鞍扩大9例,垂体柄不能辨认11例,肿块与垂体分界不清7例,无腰征。14例垂体大腺瘤：7例显著强化、但不均匀,颈内动脉包绕14例,短脑膜尾征9例,较多流空信号2例,蝶鞍扩大14例,垂体柄不能辨认14例,见不到垂体结构13例,腰征12例。鞍结节脑膜瘤的瘤体显著及均匀强化、脑膜尾征粗大、瘤内星状改变均明显不同于垂体大腺瘤,其中长脑膜尾征、明显及均匀强化价值最大。结论 长脑膜尾征和肿瘤明显及均匀强化、无腰征是鞍结节脑膜瘤的特征性表现,对于鉴别鞍结节脑膜瘤与向前上生长的垂体大腺瘤具有重要价值。     

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。     

Acromegaly due to an ectopic pituitary adenoma in the sphenoid sinus

An ectopic pituitary adenoma, exclusively involving the sphenoid sinus, associated with a normal size pituitary gland and an empty sella is a rare clinical entity. Only four cases have been found in the literature. We describe the case of a 47-year-old woman with clinical and biochemical acromegaly. Computed tomography (CT) appeared to show expansion of the sellar floor inferiorly into the sphenoid sinus, and magnetic resonance imaging (MRI) demonstrated an empty sella and a mass lesion confined to the sphenoid sinus. The tumor was totally resected by taking a transnasal endoscopic approach and the dura mater of the base of the pituitary fossa was confirmed intact.     

Cushing's syndrome: new variants and association with empty sella syndrome

In this article we propose a review of the literature on clinical variants of Cushing's syndrome (CS) and personal observations on one of these variants. Clinical variants of CS are: (1) tumors of the intermediate pituitary lobe; (2) hypothalamic Cushing's with pituitary hyperplasia; (3) cyclic CS; (4) primitive nodular adrenal dysplasia; (5) pre-Cushing's syndrome; (6) association of CS and empty sella. The personal observations relate to the association of CS and empty sella. This syndrome consists of: (a) inappropriate cortisol secretion of pituitary origin; this alteration is less pronounced in comparison with other patients affected by Cushing's disease; (b) marked hirsutism; (c) slight hyperprolactinemia or augmented PRL response after metoclopramide; (d) elevated DHEAS levels.     

MR imaging of pituitary morphology in idiopathic intracranial hypertension

The aim of this study was to investigate the morphologic changes of the pituitary gland in patients with the clinical diagnosis of idiopathic intracranial hypertension (IIH). Qualitative and quantitative analyses of pituitary morphology were performed in normal subjects (n = 23), patients with the clinical diagnosis of IIH (n = 40), and patients with acute increased intracranial pressure (AICP; n = 37) caused by acute head trauma. The loss of pituitary height (concavity) on the sagittal T1-weighted image was classified into five categories: I = normal, II = superior concavity that was mild (<(1/3) the height of the sella), III = moderate (between (1/3) and (2/3) concavity of height of sella), IV = severe (>(2/3) concavity of height of sella), and V = empty sella. The area ratio of pituitary gland to sella turcica measured in the midsagittal plane was quantified. Clinical records were retrospectively reviewed to correlate with magnetic resonance (MR) findings. Using moderate concavity (>(1/3)) as the minimum criterion for abnormality, IIH patients had an 85% incidence of morphologic changes with 80% sensitivity and 92% specificity. Empty sella (almost complete concavity of the sella) was found in only 2.5% of patients with IIH. Quantitative analysis of the pituitary gland/sella turcica area ratio showed a significant decrease in patients with IIH (P < 0.0001) but no significant difference between the normal subjects and AICP patients. A posterior deviation of the pituitary stalk was seen in 43% of patients. No enlargement of the ventricles or sulcal effacement was seen in IIH patients. Routine brain MR examination of patients with IIH frequently shows morphologic changes of the pituitary gland ranging from various degrees of concavity to (rarely) the extreme case of an empty sella. The etiology is unknown and may be related to the severity and duration of elevated CSF pressure. Such findings may be useful to facilitate the diagnosis of IIH, particularly in patients with equivocal clinical findings or when IIH is not suspected. J. Magn. Reson. Imaging 2000;12:808-813.     

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.     

Primary empty sella. Incidence in 500 asymptomatic subjects examined with magnetic resonance]

In 500 consecutive patients, aged 11-82 years, who underwent MR imaging of the brain for a variety of conditions not related to pathologic processes of the sellar or juxtasellar regions, the authors detected primary totally empty sella in 28/248 males (11.3%) and in 34/252 females (13.5%). Primary partially empty sella was found in 40/248 males (16.1%) and in 38/252 females (15.1%). A progressive increase in the incidence of the signs of primary empty sella was observed with aging, the increase being more conspicuous in the 5th decade of life in females (37.5%) and in the 6th decade in males (40%). On the whole, signs of primary empty sella were detected in 140/500 cases (38%)--namely, in 9.6% of the subjects under 40 and in 39.9% of those above 40. The incidence of primary empty sella, unrelated to any other clinical condition, seems to support its inclusion into paraphysiologic variants. On the basis of the data reported in literature, the authors consider the factors possibly playing a role in this condition. They seem to be: insufficiency or absence of diaphragma sellae, CSF pressure, and pituitary involution related to aging.     

Dynamic roentgenographic changes in the empty sella syndrome.

Two cases of empty sella syndrome are presented. Progressive sellar enlargement was documented together with evidence of increased intracranial pressure. One patient exhibited de novo development of an empty sella turcica.     

Gd-DTPA在垂体高PRL微腺瘤诊断中的应用研究

目的：提高在高场强（１．５Ｔ）条件下磁共振对垂体ＰＲＬ微腺瘤的精确显示。方法：作者对６２例高ＰＲＬ垂体微腺瘤患者采用不同的Ｇｄ－ＤＴＰＡ造影方法。结果：静脉缓慢推注小剂量Ｇｄ－ＤＴＰＡ（０．０５ｍｍｏｌ／ｋｇ，１．７ｍｌ／ｍｉｎ），５４例中４６例取得满意的对比效果，同时发现４１例在Ｔ１加权冠状位图像上鞍底高或稍高信号带中断或部分缺失。结论：使用高场强磁共振机，静脉缓慢推注小剂量Ｇｄ－ＤＴＰＡ能更好地显示垂体高ＰＲＬ微腺瘤的全貌，Ｔ１加权图像上鞍底高或稍高信号带中断或部分缺失征象提示为肿瘤对鞍底的早期侵蚀或压迫。     

A new variety of "empty sella" with cystic intrasellar dilatation of the recessus infundibuli.

A new variety of the "empty sella" consisting of polycystic intrasellar dilatation of the infundibular recess is described. The underlying embryonal developmental anomaly of the pituitary gland and diaphragma sellae and the possible effect of increased intracranial pressure are discussed and the malformation is compared with embryonal stages of ventricular development.