原发性垂体柄占位性病变的诊断和手术治疗(附10例报告)

目的：探讨垂体柄占位性病变的影像学诊断及手术方法。方法：回顾性分析10例垂体柄占位性病变的MR资料，其中男4例，女6例，平均年龄32岁。结果：MR的特征性表现为垂体柄球形增粗，3例生殖细胞瘤，T1、T2等信号，强化均匀一致，其中，1例经手术病理证实，3例均行放射治疗，疗效明显；7例Rathke’s囊肿，T1等、低信号，T2高信号，包膜环形强化，均行手术切除病理证实诊断。结论：MR可以清楚的显示原发性垂体柄占位形态，有别于继发性病灶，生殖细胞瘤放疗疗效肯定。

The diagnosis and surgical treatment of space-occupying lesions in pituitary stalk

Objective To study the diagnosis of the space-occupying lesions in pituitary stalk and explore the surgical methods. Methods 10 patients (4 males, 6 females, with an average age of 32 years) with space occupying lesions in pituitary stalk received MR examinations, 5 receiving right pterional approach and 3 transphenoid approach. Pathological examinations were performed. Results 3 cases were diagnosed to be germinoma, and MR showed ball-like thickening of pituitary stalk, equal signals on T1 and T2. Among them, 1 was confirmed through operation pathologically. All the 3 cases were given radiotherapy, with marked therapeutic efficacy. Another 7 were Rathke's cysts and MR showed equal and low signals on T1 but high signals on T2 and loop-like lesion envelope after enhancement. All were confirmatively diagnosed pathologically by resection. Conclusion MR can show shapes and sizes of space occupying primary lesions in pituitary stalk. Radiotherapy is effective in the treatment of germinoma.