不同激素分泌类型垂体巨腺瘤的磁共振成像特点

目的:探讨不同激素分泌类型垂体巨腺瘤的磁共振成像影像特点.方法:回顾性分析64例不同激素分泌类型垂体巨腺瘤在MRI上的信号强度、最大径、其向蝶鞍上下延伸生长的高度,及其有无海绵窦侵犯;同时22例无分泌功能垂体巨腺瘤作为对照组纳入.结果:64例不同激素分泌类型垂体巨腺瘤患者中,生长激素(GH)细胞腺瘤16例,泌乳素(PRL)细胞腺瘤36例,促肾上腺皮质激素(ACTH)细胞腺瘤5例,多种激素细胞腺瘤7例.T1WI等信号在GH及多种激素细胞腺瘤中最常见;T2WI等、低信号在GH、ACTH及多种激素细胞腺瘤中常见,而T2WI高信号在PRL及无分泌功能细胞腺瘤中常见;GH细胞腺瘤鞍上生长高度明显低于其他几种腺瘤,倾向于向鞍下生长;各类型腺瘤的海绵窦侵犯无明显差异.结论:几种不同激素分泌类型垂体腺瘤中,GH、多种激素细胞腺瘤的MRI信号强度,以及GH细胞腺瘤的生长延伸方向具有一定的特征.

MRI Findings of Pituitary Macroadenoma of Different Hormone-secreting Type

Objective:To assess MRI findings of pituitary macroadenoma of different hormone-secreting type. Methods: A total of 64 pathologically proven different hormone-secreting pituitary macroadenomas were evaluated retrospectively on magnetic resonance (MR) images to determine the signal intensity,maximum diameter,amount of suprasellar and infrasellar extension,and cavernous sinus invasion;22 nonfunctioning macroadenomas were analyzed as a control.Results:Among 64 different hormone-secreting pituitary macroadenomas,16 were GH-producing adenomas,36 were PRL- producing adenomas,5 were ACTH- producing adenomas,7 were multi-hormone- producing adenomas.On T_1-weighted MR images,isointensity was seen more commonly in GH-producing adenomas and multi-hormone-producing adenomas than in other adenomas.On T_2-weighted MR images,iso-or hypo-intensity was seen more commonly in GH-producing adenomas,ACTH- producing adenomas,and multi-hormone- producing adenomas,but hyperintensity was seen more commonly in PRL- producing adenomas and nonfunctioning adenomas.Average suprasellar extension was significantly smaller in GH-producing adenomas than in other adenomas.GH-producing adenomas tended to demonstrate infrasellar extension rather than suprasellar extension.No significant difference was seen in the frequency of cavernous sinus invasion between pituitary adenomas of different hormone-secreting type.Conclusion:Among different hormone-secreting pituitary macroadenomas,the MR signal intensity is characteristic features of GH-producing adenomas and multihormone- producing adenomas,and the growth direction is another characteristic feature of GH-producing adenomas.