厌色细胞垂体瘤CT、MRI影像与病理对照研究

目的：探讨厌色细胞垂体瘤CT、MRI影像形成的病理基础。方法：分析26例厌色细胞垂体瘤的CT、MRI平扫及增强MRI与术中所见和病理学结果进行比较。对于海绵窦受侵；颅底骨质受侵、突入蝶窦；颈内动脉粘连包裹受侵进行重点分析。结果：术前较明确诊断垂体瘤22例；海绵窦受侵和颈内动脉粘连包裹受侵无一漏诊，假阳性率为27．3％和36．4％。CT、MRI影像能显示出血和坏死、囊变、变性，颅底骨质受侵病灶无一漏诊，但有5．5％假阳性率。术中判断血供丰富3例、血供一般17例，与CT、MRI影像无对应关系。3例垂体瘤病理学表现为瘤细胞有核异型性及核分裂像。结论：CT、MRI影像能较明确地诊断垂体瘤出血和坏死、囊变、变性、颅底骨质受侵病灶。能敏感地显示海绵窦受侵和颈内动脉粘连包裹受侵，但可出现假阳性。对血供的判断不准确，不能提示垂体瘤生物学特性。

Image and pathological study of the chromophobe adenoma

Objective： To discuss the pathological basis to image on CT and MRI of the chromophobe adenoma. Methods： To review CT and MRI images and pathology results obtained from 26 chromophobe adenoma patients, especially analyze cavernous sinus invasion, base of skull invasion ,sphenoidal sinus invasion,internal carotid artery adhesion invasion. Results： Twenty two correct diagnosis before operation, including all cavernous sinus invasion and internal carotid artery adhesion invasion cases, false positive rates were 27.3 percent and 36.4 percent. CT and MRI images can display hemorrhage,putrescence, denaturalization and base of skull invasion. But had 5.5 percent of false positive rate. During the operations, 17 cases were normal bloody supplied; and 3cases had abundance supplication of blood, without any relationships to the images. 3 casespathology showed nuclear atypia and caryocinesia. Conclusion： CT and MRI images can more definitely display nidi of hemorrhage, putrescence, denaturalization and base of skull invasion ; further more, images can sensitively display nidi of cavernous sinus invasion and internal carotid artery adhesion invasion, with some false positive cases. But the images can not offer the correct estimation of the bloody supply, and can not present adenomas＇ecology.