中枢性尿崩症的MR影像诊断(附65例分析)

目的：分析中枢性尿崩症（ＣＤＩ）的ＭＲ表现，探讨ＭＲ在ＣＤＩ的影像诊断中的价值及限度。材料与方法：对１９９６－０６～１９９６－０７间所确诊的６５例ＣＤＩ患者的ＭＲ资料和临床资料进行了回顾性分析。结果：１、ＭＲ表现：鞍内／鞍上肿块１６例；垂体柄断裂或显示不清１４例；垂体柄增粗１０例；垂体柄结节５例；垂体后叶高信号消失５８例。２、引起ＣＤＩ的病因：头颅损伤６例；颅内肿瘤１７例；Ｌａｎｇｅｒｈａｎ＇ｓ组织细胞增生症２例；特发性ＣＤＩ１７例。有２３例继发性ＣＤＩ的病因未经病理证实。结论：低场强（０．３Ｔ）的ＭＲ机器能够清楚地显示下丘脑－垂体区的病变，对ＣＤＩ病因的诊断和治疗具有重要的价值，但对肿瘤及炎性病变的定性诊断有一定的限度，同时认为临床上划分的部分性ＣＤＩ和完全性ＣＤＩ的ＭＲ影像表现不存在差别。

MR Imaging Diagnosis of Central Diabetes Insipidus (Analysis of 65 Cases)

Purpose: To analyse MR manifestations of central diabetes insipidus (CDI) and to evaluate the value of MR in the diagnosis of CDI causes. Material and methods: MR images and clinical data of 65 cases of CDI were retrospectively analyzed. Results: 1. MR manifestations: 16 cases with intrasellar or suprasellar mass, 7 cases with transection of the pituitary stalk; 10 cases with thickening of the pituitary stalk, 5 cases with nodule within the pituitary stalk and 58 cases with loss of posterior pituitary hyperintensity (PPH). 2. Causes of CDI: 6 cases with cranial trauma, 17 cases with cranial neoplasm, 2 cases with Langerhan's cell histiocytosis, 17 cases with idiopathic CDI and the 23 cases lack of pathological evidence. Conclusion: The MR machine with low field magnets (0.3T) could also clearly demonstrate lesions in the hypothalamic pituitary region. MR has important value in the diagnosis of CDI cause and the follow up of its treatment, but has some limits in the differential diagnosis of neoplastic or inflammatory lesions involving the hypothalamic pituitary region. There is no difference between partial and complete CDI on MR images.