MRI推断垂体腺瘤质地、侵袭性与经蝶入路术中所见的比较

目的 探讨依据MRI推断垂体腺瘤的质地、侵袭性的意义。方法 回顾性分析200例经蝶人路切除垂体腺瘤的临床资料、MRI信号特点及手术情况。结果 138例R像为高信号，肿瘤质软。T2像稍高信号24例，质地中等。T2像等、低信号38例，腺瘤质韧。MRI显示165例侵袭周围结构，术中发现有侵袭征象126例，病理报告显示139例鞍底硬膜被肿瘤侵袭，36例蝶窦黏膜有肿瘤侵袭。结论 MRI检查T2像信号强度与垂体腺瘤的质地有关；对垂体腺瘤的侵袭性应根据MRI、术中所见及病检作综合判断。

The comparison of consistence, invasiveness of pituitary adenoma judgement by MRI with intraoperative findings in transsphenoidal approach

Objective To discuss the significance of MRI judgement on pituitary adenomas consistence and invasiveness. Methods Analysis of clinical presentation, MR imaging signal characteristic and intraoperative findings. Results 138 cases were with long T 2MR signal, adenomas with soft texture, 24 cases with longer T 2MR signal consistence moderate, 38 cases were with equal, shorter T 2MR signal consistence hard. MRI showed 165 cases invasiving the surrounding structure. 126 cases were found invasive sign intraoperative. Pathological report showed the sellar floor dural of 139 cases and 36 cases sphenoidal sinus mucosa were invasived. Conclusions There is relationship between the signal of T 2 weight and pituitary adenomas consistence. It should be made a comprehensive judgement on invasiveness of pituitary adenoma according to MRI, intaoperative findings and pathological examination.