547例垂体腺瘤延迟诊断原因及影像诊断分析

目的:提高垂体腺瘤特别是微腺瘤早期影像诊断率。方法:通过对所搜集病史资料完整,经医学影像学确诊和手术病理证实的547例垂体腺瘤(内有251例微腺瘤)延迟诊断原因的分析,找到影响垂体腺瘤早期诊断的因素。结果:296例垂体大腺瘤蝶鞍X线平片、CT、MR常规检查即可诊断。CT骨窗蝶鞍片有助于垂体微腺瘤的诊断,251例微腺瘤经高分辨力CT薄层冠状强化扫描和高场强MR薄层强化扫描得以明确诊断。结论:熟悉垂体腺瘤的首发症状,及时行CT、MR常规扫描可明确大腺瘤的诊断,CT骨窗片可发现垂体微腺瘤的佐证。高场强MR薄层强化扫描是目前诊断垂体微腺瘤的最佳方法,高分辨力CT冠状薄层强化扫描次之,结合神经内分泌学检查是提高垂体腺瘤影像学早期诊断率的主要措施。

The cause of delayed diagnosis and imaging diagnosis of pituitary adenoma (analysis of 547 cases)

Objective:To improve the diagnostic rate of pituitary adenoma,especially the pituitary micro-adenoma.Methods:547 cases with pituitary adenomas proved by medical imaging,surgery and pathology(including 251 micro-adenomas),we analysed the causes of delayed diagnosis and found the factors which influence the early diagnosis of pituitary adenomas.Results:296 cases big pituitary adenomas can be diagnosed by X-ray films and general scan of CT and MR.CT bone window film is helpful for diagnosis of micro-adenomas.Conclusion:Be familiar with the first symptom of pituitary adenoma,doing general scan of CT and MR can make the diagnosis of big pituitary adenoma clear,CT bone window film can find the micro-adenomas.The lamellar enhanced scan of high magnetic field MR is the best way for diagnosis of micro-adenomas now,coronary lamellar enhanced scan of high-resolution CT is the second,consulting endocrinology,it is the main method to improve the early diagnostic rate of pituitary adenoma.