垂体卒中的CT,MRI与临床对照研究

分析垂体卒中ＣＴ，ＭＲＩ表现与临床表明，探讨ＣＴ，ＭＲＩ对垂体卒中的诊断价值。材料和方法：对手术和病理证实的４６例垂体卒中进行回顾性分析。男性２０例，又性２６例，年龄２３～６９岁，平均４４岁。４６岁中，３２例行ＣＴ检查，其中单纯平扫７例，平扫＋增强２５例；４６例均作ＭＲＩ检查，其中单纯平扫１４例，平扫＋增强３２例。结果：４６例均为垂体大腺瘤基础上并发出血和（或）坏死。３２例ＣＴ检查中，垂体瘤出血１

Comparison Study on CT,MRI and Clinical Presentations of Pituitary Apoplexy

Purpose: To investigate the value of CT and MRI in the diagnosis of pituitary apoplexy by analyzing the CT, MRI and clinical appearances. Materials and Methods: Forty six cases of pituitary apoplexy , proven surgically and pathologically , were analyzed retrospectively. The age of 20 men and 26 women ranged from 23 to 69 years(mean 44 years). 32 patients underwent CT examinations with (n = 25) and without(n = 32) intravenous injection contrast media. MRI were carried out for 46 cases and 32 of them had Gd - enhanced T1 WI studies. Results: All the 46 cases of pituitary apoplexy suffered from a sudden hemorrhage or infarction of pituitary macroadenomas. Among 32 plain CT scans, 17 cases showed patchy high density shadows compat- ible with hemorrhage of pituitary rnacroadenomas. 7 cases showed irregular hypodensity area within the tumors mass compatible with necrosis, and 8 showed iso - , hyper - and hypo - mixed density in the tumor compatible with hemorrhage accompanying with necrosis. No enhancement could be revealed in the areas of hemorrhage and necrosis on the postcontrast CT images. MRI findings of 46 cases included: 29 cases of hemorrhage in tumors with high intensity on both T1 WI and T2 WI; 10 cases of necrosis with low intensity on T1 WI and high intensity on T2 WI; 8 cases of hemorrhage and necrosis. No enhancement could be seen in the areas of hemorrhage and necrosis on the post - contrast MR images. The clinical presentations were abrupt onset of one or more of the following symptoms, including severe headache(n = 26); visual disturbance (n = 22); oculomotor nerve parests(n = 13); nausea and vomitting(n = 8); altered mental status(n = 7); meningeal irritation(n = 6); hemiplegia(n = 4) and fever(n = 2). Conclusion: CT and MRI combined with clinical presentations are of great value in the diagnosis , treatment and follow up of pituitary apoplexy.