颅咽管瘤的MRI诊断及鉴别诊断颅咽管瘤的MRI诊断及鉴别诊断

目的:研究颅咽管瘤的MRI诊断及鉴别诊断。方法:回顾性分析经病理证实的13例颅咽管瘤的MRI表现。结果:9例呈圆形或类圆形，4例呈不规则形。平扫6例表现为长T1长T2信号，3例表现为等T1长T2信号，2例短T1长T2信号，1例等T1短T2信号，1例混杂T1混杂T2信号。其中囊内见出血1例，分层征象2例，钙化3例，壁结节4例，3例DWI弥散不受限呈低信号。增强后3例实性颅咽管瘤和5例囊实性颅咽管瘤实性部分明显均匀或不均匀强化，5例囊实性和4例囊性颅咽管瘤囊壁呈弧形或环形强化，4例囊性颅咽管瘤壁结节明显强化，1例囊性颅咽管瘤未见明显强化。结论:颅咽管瘤的MRI影像表现具有一定特征，但需注意与垂体腺瘤、Rathke囊肿、生殖细胞瘤等鉴别。

MRI diagnosis and differential diagnosis of craniopharyngiomas

Objective:To study MRI diagnosis and differential diagnosis of craniopharyngiomas.Methods:MRI findings of 13 patients with histologically confirmed craniopharyngiomas were retrospectively analyzed.Results:MRI findings showed circular and elliptical shapes (n=9),irregular shapes (n=4).MRI findings showed long T1 and long T2 signals (n=6),isointense T1 and long T2 signals(n=3),short T1 and long T2 signals(n=2),isointense T1 and short T2 signals(n=1),mixed T1 and mixed T2 signals (n=1).MRI findings showed hemorrhage(n=1),stratified sign(n=2),calcification(n=3),intracystic nodules(n=4) of craniopharyngioma cyst.The diffusion was unlimited in DWI which showed hypo-intense singnal(n=3).After Gd-DTPA,the solid components of solid craniopharyngiomas (n=3) and solid-cystic craniopharyngiomas (n=5) showed obvious homogeneous or inhomogeneous enhancement.The cyst wall of solid-cystic craniopharyngiomas (n=5) and cystic craniopharyngiomas (n=4) showed curve or peripheral enhancement.The intracystic nodules of cystic craniopharyngiomas (n=4) showed obvious enhancement.Cystic craniopharyngiomas (n=1) didn' t show obvious enhancement.Conclusion:MRI findings of craniopharyngiomas show some characteristics while we still need to identify the features of hypophysoma,Rathke cyst and germ cell tumor.