脑垂体脓肿15例CT和MRI表现及临床病理研究

目的:探讨脑垂体脓肿的影像学特点。方法 :15例经手术和病理证实的垂体脓肿患者,术前均行CT扫描和鞍区MRI平扫及增强扫描。结果 :CT示7例鞍区呈等密度,5例呈低密度,1例呈略高密度病灶,2例呈混杂密度病灶,边界均清楚;MRI示11例长T1,长T2信号,2例呈等T1,长T2信号,13例显示增强后可见囊壁环形强化,且冠状位上均可见垂体柄增粗及强化,为中枢性尿崩提供了形态学上的线索。结论:垂体脓肿的影像学有特征性,术前CT提示鞍区边界清楚的等密度或略高密度病灶,鞍区磁共振及增强示类圆形囊状占位性病变,等或长T1,长T2,囊壁呈环形强化,伴蝶窦内粘膜增厚等,尤其是术前合并尿崩者应考虑垂体脓肿的诊断。

CT and MR features of pituitary abscess and clinical pathological analysis

Objective:To analyze CT and MRI features pituitary abscess.Methods:15 cases of pituitary abscess were all proved by operation and pathology,All cases were examined by CT/MR plan scan and MR contrast scan before opertion.Results:7 cases appered isodensity on CT plan scan in pituitary area,5cases showed hypointensity,1cases showed hyperintensity and mixed density in 2 cases with clear edge.11 cases showed high T1WI and high T2WI signal,2cases showed equal T1WI and high T2WI signal on MRI,13 cases showed contrast show ring shape enhancement and showed "pear sign" at coronal position.Conclusion:The onset of pituitary abscess has an obvious tendency of increasing.A diagnosis of pituitary abscess should be seriously considered when radiographic features shows a sellar mass,iso-or hyperintense on T1-weighted images,hyperintense on T2-weighted images,ring enhancement and so on.