术前MRI评价垂体瘤质地与病理学对照研究

背景与目的：垂体瘤的质地影响手术切除的难易,术前预测垂体瘤的质地对手术入路选择有指导意义。本探讨术前MRI预测实质性垂体瘤质地的可能性及其病学基础。方法：连续搜集20例经蝶手术切除的垂体瘤标本,术前行MRI检查,术中根据肿瘤硬度分为质地软,中等,韧。标本行HE染色和1型胶原免疫组化染色－自动图像分析。结果：10例质软,T2WI瘤体／白质信号强度比均值2．34,I型胶原阳怀面积比均值17．38％,6例质地中等,T2WI瘤体／白质信号强度比均值2．01,I型胶原阳性面积比均值27．30％,4例质地坚韧,T2TI瘤体／白质信号强度比均值1．56,I型胶原阳性面积比均值40．31％,三组之间I型胶原阳性面积比有显著差异（P＜0．01）,T2WI瘤体／白质信号强度比有显著差异（P＜0．01）,I型胶原阳性面积比和T2WI上瘤体／白质信号强度比有显著负相关（P＜0．01）。结论：I型胶原含量影响垂体瘤的质地,MRI可以预测垂体瘤的质地,在T2WI上显示较低信号强度的垂体瘤质地较韧。

Controlled pathological study and preoperative MRI evaluation of the consistency of pituitary adenomas

Background &objective:Consistency of pituitary adenoma may influence surgical remote of the tumor.Preoperative evaluation of tumor consistency will be usefull in guiding the operative approach.This study was designed to investigate the relationship among pituitary adenoma consistency,collagen type I and MRI signal intensity.Methods:Twenty pituitary adenoma patients received transsphenoidal surgery.Preoterative MRI,H E stains and collagen type I immunohistochemistry(IHC) autonomic image analysis for tumor specimens were performed Results:Ten tumors were soft,mean T2WI tumor/while matter signal intensity ratio (TWSIR) is 17.38%;six were moderate,mean T2WI TWSIR was 2.01;and 4 were firm,mean T2WI TWSIR was 1.56.Mean collagen type I positive area ratio(C1PAR) of soft,moderate,and firm tumors was 17.38%,27.30%,and 40.31%,respectively.Both C1PAR and T2WI TWSIR were significantly different among three types (P< 0.01) C1PAR was negatively correlated to T2WI TWSIR(P< 0.01).Conclusion:Collagen type I content relates with the consistency of pituitary adenomas.MRI can predict of pituitary consistency adenoma;and those show hypointensity in T2WI are firm.