Haemorrhagic acoustic neuroma with features of a vascular malformation

A 55-year-old man with hearing loss presented with vertigo and vomiting. CT tomography and MRI demonstrated a cerebellopontine angle mass with foci of haemorrhage. An angiomatous tumour, with large abnormal veins adhering to the capsule, was completely removed. Histologically, the tumour was an acoustic neuroma with abnormal vascularisation and limited intratumoral haemorrhage. Received: 9 July 1998 Accepted: 27 January 1999     

Imaging of giant pituitary adenomas

We present five proven giant pituitary adenomas studied by CT and MRI, and review the clinical and imaging findings. Our aim was to examine the radiologic appearances and to search for criteria useful in distinguishing these tumors from other sellar and suprasellar tumours, mainly craniopharyngioma. The main differences from small adenomas were high prevalence of macrocysts, a more invasive behaviour and a clinical picture dominated by mass effect rather than endocrine disturbance. Factors supporting the diagnosis of pituitary adenoma in a giant intra- and suprasellar mass include: infrasellar extension, absence of calcification and presence of low-signal cysts on T1-weighted images. Received: 13 October 1997 Accepted: 25 February 1998     

K空间中心部分采集技术的垂体动态增强扫描

目的：研究ｋｅｙｈｏｌｅ技术的临床应用，探讨正常垂体增强时间及增强方式；对比动态与非动态扫描垂体微腺瘤的显示情况。材料与方法：随机选择３０例女性无垂体病变及症状者作为对照组；垂体微腺瘤组３０例。ｋｅｙｈｏｌｅ动态增强扫描方法为０．１ｍｍｏｌ／ｋｇ钆喷酸葡胺静脉注射后第１０秒钟开始动态扫描垂体。结果：正常垂体组显示垂体在开始注射造影剂后２７秒开始从垂体柄向腺垂体逐步强化，７５秒时达到最高持续水平，呈均匀高信号。动态增强扫描显示垂体微腺瘤２８例，常规增强扫描显示１９例。增强前、后呈相对低信号。常规增强扫描阴性病例，动态增强扫描显示病灶逐渐强化，延迟后期呈等信号。结论：动态ｋｅｙｈｏｌｅ技术能显示正常垂体增强时间及方式，能更敏感地发现垂体微腺瘤。     

垂体微腺瘤MRI诊断(附25例分析)

目的：探讨和总结25例垂体微腺瘤的磁共振成像（MRI）表现。方法：对25例经MRI平扫：冠状位于SE序列T2加权成像（T2WI）、FFE序列T1加权成像（T1WI）,及行Gd-DTPA增强扫描：冠状位下FFE序列T1WI、矢状位下FFE序列T1WI检查,经手术切除得到病理证实的病例进行分析,其中7例行动态增强和延迟扫描。结果：25例垂体微腺瘤均位于垂体前叶,单发19例,其中14例位于垂体右侧部,多发6例。MRI平扫24例（T1WI）为低或稍低信号、1例为高或稍高信号;23例（T2WI）为高或稍高信号,但2例为等或稍低信号,增强后即刻扫描25例均为低或稍低信号,7例动态增强扫描延迟25－30min后1例有明显强化。结论：垂体微腺瘤MRI表现有一定特征性,MRI对诊断垂体微腺瘤有较大价值。     

MRI of a pituitary cryptococcoma simulating an adenoma

We describe a rare pituitary cryptococcoma in an immunocompetent patient, with radiological features similar to those of a pituitary macroadenoma. Although unusual, it should be added to the list of differential diagnosis of pituitary masses. Contrast enhancement of adjacent meninges differentiated the lesion from an adenoma.     

侵袭性垂体腺瘤的MRI诊断价值

目的 研究侵袭性垂体腺瘤的MRI影像特征。方法 回顾分析32例经手术及病理证实的侵袭性垂体腺瘤的MRI表现。结果 侵袭性垂体腺瘤的MRI影像学表现:①肿瘤超过颈内动脉(ICA)外侧壁切线;②海绵窦外侧静脉丛间隙消失;③3个或3个以上海绵窦静脉丛间隙消失;④窦内颈内动脉(ICA)被包绕50%以上,甚至被完全包裹。结论 MRI以无创伤、无骨伪影、软组织分辨率高、解剖背景清楚及三维成像等优点,是术前诊断侵袭性垂体腺瘤最主要和最重要的检查手段。     

垂体脓肿的MRI诊断(附5例报告)

目的:分析垂体脓肿的MRI表现特点。方法:回顾性分析5例垂体脓肿的病例资料,并结合文献探讨垂体脓肿的MRI诊断。结果:本组5例MRI平扫均显示垂体增大,T1WI呈低、稍低或混杂信号,T2WI呈高、稍高或混杂信号。增强扫描病灶均呈环状强化,4例壁薄且较均匀,1例壁较厚且厚薄不均。2例病灶周围出现类圆形强化小子灶,3例累及垂体柄、视交叉。结论:垂体脓肿的MRI增强表现具有一定的特征性。     

垂体脓肿的CT和MR表现

目的:分析垂体脓肿的CT和MR表现特征,以提高诊断的准确性。方法:对经过手术病理证实的12例垂体脓肿的CT和MR资料,结合文献进行回顾性分析。结果:CT平扫呈等或低密度,MR平扫T1WI呈等低或等高混杂信号,T2WI呈高信号或高低混杂信号,7例MR增强后呈均匀薄环状强化。12例中3例见正常垂体,3例垂体柄增粗强化,2例伴邻近脑膜轻度强化,5例伴副鼻窦炎。结论:垂体脓肿症状、体征及CT和MRI表现与其他鞍区囊性病变不易鉴别,但是根据增强前后的特征性表现,有可能在术前作出正确诊断。     

MRI of pituitary adenomas in acromegaly

Adenomas causing acromegaly represent at least a quarter of pituitary adenomas. We studied 12 patients presenting with active acromegaly due to a pituitary adenoma with a 1.5 T superconductive MRI unit. All had T1-weighted sagittal and coronal sections before and after Gd-DTPA; six had coronal T2-weighted images. Surgical correlation was obtained in seven patients. Histologically, there were eight growth hormone (GH)-secreting and three mixed [GH and prolactin (PRL) secreting] adenomas, and one secreting GH, PRL and follicle-stimulating hormone. Macroadenomas (10) were more frequent than microadenomas (2). No correlation was found between serum GH and tumour size. There were nine adenomas in the lateral part of the pituitary gland; seven showed lateral or infrasellar invasion. Homogeneous, isointense signal on T1- and T2-weighted images was observed in six cases. Heterogeneous adenomas had cystic or necrotic components. Received: 29 April 1996 Accepted: 8 August 1996     

MRI of pituitary adenoma with extensive amyloid formation

We report a patient with a pituitary adenoma with extensive amyloid formation. T2-weighted MRI was most characteristic for amyloid deposition. Received: 30 July 1998 Accepted: 20 October 1998     

正常成人垂体的磁共振测量研究

目的:观察正常垂体形态、测量其大小并探讨其与年龄、性别的变化关系。方法:选取300例非鞍区病变及内分泌症状的正常成年人。按性别、年龄分为5组:20~29岁组,30~39岁组,40~49岁组,50~59岁组及60岁以上组,每组男女各30例,MRI测量矢状位腺体及后叶前后径、高径以及垂体柄前后径;冠状位腺体宽径、高径及垂体柄宽径;比较分析不同性别、年龄段上述各径线MR测量值的变化特点。结果:成人男、女正常垂体冠状高径分别为(4.01±1.08)mm、(3.99±1.37)mm,冠状宽径分别为(9.75±1.63)mm(、10.17±1.59)mm;矢状高径分别为(4.46±1.24)mm(、4.68±1.61)mm;前后径分别为(10.15±1.51)mm(、10.24±0.90)mm;垂体后叶矢状高径分别为(4.01±1.43)mm(、4.59±1.17)mm,前后径分别为(2.01±0.66)mm、(1.98±0.70)mm;垂体柄冠状宽径分别为(1.56±0.21)mm、(1.59±0.21)mm,前后径分别为(1.50±0.23)mm、(1.52±0.22)mm。垂体高径在20~29年龄组最大,有随年龄增大而逐渐减小趋势;垂体宽径及前后垂体后叶及垂体柄各径线有先增大后减小趋势。结论:成人垂体各径线随年龄的变化有先变大后减小趋势。各径线与年龄有一定统计学差异而与性别无明显统计学差异。     

脑肿瘤磁共振波谱成像检查中的质量控制

目的探讨脑肿瘤磁共振波谱学检查技术及图像质量影响因素。方法分析137例接受磁共振波谱学检查的脑肿瘤患者的影像学资料。结果优质的图像使检查更易行可靠,更有助于影像诊断。结论检查技术参数的合理选择有助于提高影像质量,是质量控制的关键。     

垂体发育不良的影像学诊断现状

垂体发育不良是垂体功能低下的重要原因之一,影像学检查为诊断垂体发育不良的重要手段,本文综述垂体发育不良的影像学诊断及其在临床工作中的重要意义。     

动态MRI对垂体微腺瘤的诊断价值

目的　评价匙孔动态MR对垂体微腺瘤的应用价值。方法　回顾性分析临床有头痛、闭经、泌乳、过度肥胖或肢端肥大等症状的 53例经手术和临床证实的垂体微腺瘤的MR影像资料 ,由2位有经验的影像科医师在相互隔离、不知道临床及实验室资料的情况下对 53例的动态MRI、MR传统增强及冠状面平扫T1 WI分级 ,并得出一致结果。分级标准为 :0级 :垂体内未见异常信号 ;Ⅰ级 :垂体内信号不均匀 ;Ⅱ级 :垂体内见有粟粒、结节或片块状的异常信号区。将动态MR、MR传统增强及平扫图像分级的结果进行比较。结果　本组动态MR垂体内未见异常信号者 (0级 ) 1例 ,垂体内信号不均匀者 (Ⅰ级 ) 2 9例 ,垂体内见有粟粒、结节或片块状的异常信号区者 (Ⅱ级 ) 2 3例 ;MR传统增强 0级 2 6例 ,Ⅰ级 1 7例 ,Ⅱ级 1 0例 ;MR平扫 0级 39例 ,Ⅰ级 1 0例 ,Ⅱ级 4例。本组动态MR检出率为 98 1 % ;传统增强MR检出率为 51 9% ;MR平扫检出率为 2 6 4%。行×列 χ2 检验 ,P <0 0 0 5。表明动态MR能明显提高微腺瘤显示的级别 ,且差异有非常显著性意义。结论　动态MR能明显提高垂体微腺瘤诊断的可靠性 ,降低MR图像模棱两可的出现率。临床怀疑垂体微腺瘤而MR平扫阴性者 ,动态MR应列为常规检查     

正常青少年垂体MRI研究

目的研究正常青少年垂体大小、形态变化及其与年龄、身高、体重的相关性。方法选取152例6．0—18．9岁正常青少年的垂体MRI资料，于SE序列T1WI头颅正中矢状及冠状面上观测垂体大小形态及信号特征。结果得到6-〈10岁、10～〈15岁、15．0—18．9岁3组正常垂体大小、形态及信号特征资料。在10-〈15岁、15．0～18．9岁组，男性隆凸型分别占47．6％（10／21）、52．0％（13／25），球形垂体分别占14．3％（13／21）、32．0％（8／25）；女性隆凸型分别占70．9％（22／31）、90．0％（18／20），球形垂体分别占45．2％（14／31）、60．0％（12／20）。青春发育期腺垂体与年龄呈正相关生长（r男=0．74，t=3．624，P=0．004；r女=0．94，t=9．562，P=0．000），与身高、体重无明显相关性（P〉0．05）。结论青春发育期垂体大小、形态变化大，随年龄增长，垂体明显增生肥大，垂体上缘也逐渐隆凸。球形垂体在青春发育期可为正常现象，在青春期女性中占有很大比率，易与垂体微腺瘤混淆，需结合临床及生化检查结果，避免误诊。     

Spontaneous regression of a pituitary cyst

We present a pituitary cyst discovered on MRI in an amenorrheic patient that regressed over months. Although the precise etiology of the cyst is unproven, documentation of pituitary cyst regression has not to our knowledge been described previously. Received: 13 February 1998 Accepted: 8 June 1998     

垂体脓肿的MRI诊断及其临床意义

目的总结垂体脓肿的MRI特征。方法回顾性总结经手术、病理和临床证实的14例垂体脓肿患者的MR平扫和增强表现，分析其影像特征。结果12例患者MR平扫示鞍区囊性改变，T1WI呈不均匀低信号，2例T1WI呈等及稍高信号。14例患者T2WI均呈高信号改变。增强后T1WI均表现为不均匀的边缘环形强化及与病灶相连的周围脑膜强化，正常垂体未能显示。MRI特征性表现为液．液平面、壁结节、强化的絮状阴影。结论垂体脓肿的MRI有其特征性，结合临床术前可以作出诊断，从而指导临床治疗方法的选择。     

Concomitant pituitary adenoma and Rathke's cleft cyst

We reviewed the clinical, radiological and surgical findings in patients with both pituitary adenoma and Rathke's cleft cyst. We retrospectively selected patients with both lesions from the 374 patients in whom a sellar/juxtasellar lesion was detected on MRI at 1.5 tesla. All patients received intravenous contrast medium. Concomitant pituitary adenoma and Rathke's cleft cyst were found in eight patients (2.1 %). The frequency of the combination was 3.5 % of pituitary adenomas and 11 % of Rathke's cleft cysts. Symptoms were always due to the adenoma, secreting adrenocorticotrophin in two patients and growth hormone in six. The adenoma was larger in five patients, and the cyst in three. The cysts gave variable signal. The adenoma was adjacent to the cyst in seven patients, and enclosed it in the other patient. As a result of experience with MRI, concomitant pituitary adenoma and Rathke's cleft cyst are now known not to be as rare as thought previously. When a nonenhancing cyst-like structure is demonstrated in a patient with pituitary adenoma, the possibility of a coexisting Rathke's cleft cyst should be considered. Received: 23 March 2000/Accepted: 12 July 2000     

Metastases from a pituitary adenoma: MRI

Few cases of pituitary adenoma with metastases have been reported. We report a case with histologically benign intracranial and cauda equina metastases. We compare it to the others in the literature. Received: 30 March 1998 Accepted: 22 January 1999     

Rathke's cleft cyst with pituitary apoplexy: case report

We report a Rathke's cleft cyst which presented as pituitary apoplexy, a rare presentation. A 46-year-old woman suffered sudden headache and visual loss. T1-weighted MRI 3 weeks after this apoplectic episode demonstrated a cystic lesion between the anterior and posterior lobes of the pituitary, with some high-signal material layering in it. The mass showed spontaneous regression on an image 3 weeks later. Trans-sphenoidal surgery confirmed the diagnosis of a Rathke's cleft cyst with a haematoma within it. Received: 30 September 1998 Accepted: 5 February 1999