颅咽管瘤MRI表现与术后水钠代谢紊乱关系分析

目的分析MRI上颅咽管瘤与第三脑室底的关系及对估计术后水钠代谢紊乱的意义.方法回顾性分析64例颅咽管瘤,根据术前MRI上颅咽管瘤与第三脑室底的关系将其分为4级,术后钠代谢情况分为正常、低钠、高钠及混合4组,尿量分为正常、轻度尿崩及严重尿崩3组,分别进行统计学分析.结果各级颅咽管瘤与钠代谢情况、尿量之间均有统计学差异.结论颅咽管瘤对第三脑室底侵袭越多,术后水钠代谢紊乱程度越重.分析MRI上颅咽管瘤与第三脑室底的关系,可以在一定程度上预测术后部分下丘脑反应的严重程度.

The relationship between preoperative MRI and postoperative disorders of sodium and water following total resection of craniopharyngioma

Objetive To estimate the MRI figures of craniopharyngiomas, especially their relation to the third ventricle floor, and their implication of postoperative sodium and water disorders. Methods A retrospective study of craniopharyngiomas after total excision was carried out in 64 patients. The data of serial postoperative sodium and fluid balance were documented to compare with the pre-operative MRI. Among them, the tumors were classified into four grades according to their infiltration to third ventricle floor; the post-operative serum sodium levels were divided into four groups (normal, hyponatremia, hypernatremia, mixture of hyponatremia and hypernatremia), and the post-operative urine volume was divided into three groups (normal, mild DI and severe DI) respectively. Results Preoperative grade of tumor infiltration was significantly associated with both postoperative serum sodium levels and urine volume. Conclusion MRI is crucial for the pre-therapeutic evaluation of craniopharyngiomas. The severity of postoperative sodium and water disorders is closely related to the degree of tumor invasion to the third ventricle floor. By analyzing the MRI figure of the craniopharyngioma, especially the tumor infiltration to the third ventricle floor, we can predict the severity of some postoperative hypothalamus disorders.