垂体瘤卒中的MRI表现和临床对照研究

目的 结合临床分析垂体卒中的MRI表现，探讨MRI对诊断、治疗垂体卒中的意义。方法 对31例垂体卒中患者行MRI检查，并结合临床症状、手术情况和病理结果进行对照研究。结果 ①本组所有病例均为大腺瘤或巨腺瘤。②MRI中瘤体出血多表现为T2WI高信号，T2WI高信号或等高混杂信号；坏死或囊变表现为T2WI低信号，T2WI高信号或等高混杂信号。根据卒中部位可分为中央型、周围型、不规则型和全瘤型。③发现垂体瘤卒中存在某些特殊的MRI表现，如靶心征，分层现象等。④本组病例中侵袭性垂体瘤占58％，非侵袭性垂体瘤占42％。PRL腺瘤占52％，其它激素腺瘤占48％。结论 MRI对于垂体卒中的诊断和治疗有很高的临床价值。侵袭性垂体瘤比非侵袭性垂体瘤，PRL激素腺瘤比其他激素腺瘤都更易出现垂体腺瘤卒中。

Clinically Controlled Study on MRI Appearances of Pituitary Apoplexy

Objective To study the MRI features of pituitary apoplexy (PA) and discuss the significance of MRI in the diagnosis and treatment of PA. Methods A controlled study on the MRI in combination with clini cal manifestations, operations and pathological findings in 31 patients with PA was performed. Results All the cases were suffered from macroadenomas or giant pituitary adenomas. The haemorrhage in PA patients showed high signal on T 1WI and high signal or iso-to hyper-signal on T 2WI; The necrotic cyst in PA pat ients displayed low signal on T 1WI and high signal or iso-to hyper-signal on T 2WI. PA could be classified as 4 types according to the position of apoplexy : center type, peripheral type, abnormal type and complete adenoma type. There w ere also some special features such as bull's-eye sign and layered sign. 58 % c ases were invasive adenomas. The PRL adenoma was accounted for 52 %. Conclusion MRI is valuable for the diagnosis or therapy of the P A. The invasive adenomas and PRL adenomas were more likely prone to PA.