Rathke囊肿国内文献469例的临床MRI分析

目的：探讨国内Rathke囊肿文献病例的常见临床和MRI表现，提高认识水平。方法分析1995年至2015年8月间的国内原始中文文献29篇469例Rathke囊肿，总结文献中患者的性别、年龄、临床症状、病变部位和MRI表现。结果患者男：女性别比约为3：4，平均年龄约37.0岁。87.4%患者出现头部不适、下丘脑-垂体功能异常和视功能障碍的临床症状，临床无症状者仅12.6%。Rathke囊肿45%位于鞍内，52.7%位于鞍内并向鞍上延伸，2.3%位于鞍上。40.3%囊肿T1WI低信号，T2WI高信号；45.8%T1WI高信号，T2WI高、等或低信号；10.1%T1WI等信号，T2WI高信号；MR增强扫描后27.7%囊肿边缘或环形强化，72.3%无强化。8.6%可见囊内结节，0.9%囊底出现沉淀物。结论国内Rathke囊肿患者女性略高于男性，平均年龄约37.0岁，多因周围结构受压出现症状而就诊。囊肿以鞍内和鞍内并向鞍上延伸常见，T1WI高信号最常见，其次为T1WI低信号和T2WI高信号组合，增强扫描后不足1/3囊肿边缘或环形强化，囊内结节和囊底沉淀物的出现率不高。

Analysis on Clinical and MRI Finding of 469 Cases with Rathke's Cleft Cysts in Chinese Literature

[Abtract] Objective To investigate the clinical and MRI findings of Rathke’s cleft cysts in Chinese literature to improve the level of cognition. Methods 469 cases with Rathke’s cleft cysts in domestic literature from 1995 to August 2015 were analyzed. The gender, age, clinical symptom, lesion location and MRI finding of the patients were summarized. Results The male and female ratio was 3:4 and the average age was 37.0 years. 87.4%of patients had head discomfort, hypothalamus and pituitary endocrine dysfunction and visual dysfunction. Only 12.6%of patients were asymptomatic. 45%of Rathke’s cleft cysts were entirely intrasellar, 52.7%were intrasellar with suprasellar extension, and 2.3%was suprasellar. On MR imaging, there were low signal on T1WI and high signal on T2WI in 40.3%of cysts, high signal on T1WI and different signals on T2WI in 45.8%of cysts, as well as isointense signal on T1WI and high signal on T2WI in 10.1%of cysts. On contrast-enhanced MR scanning, 27.7%of cysts showed circular and peripheral enhancement, except for 72.3%without enhancement. Intracystic nodule and bottom sediments were found in 8.6%and 0.9%of cysts, respectively. Conclusion Rathke’s cleft cysts in domestic literature are a little more seen in female patients than male patients with an average age of about 37.0 years. Most patients have clinical symptoms due to the compression of surrounding structures. The cysts are common in the intrasellar or intrasellar with suprasellar extension. The most common signal is high signal on T1WI, followed by low signal on T1WI and high signal on T2WI. Less than 1/3 of cysts are circularly and peripherally enhanced after contrast injection. The occurrence rate of intracystic nodule and bottom sediments is not high.