鞍旁海绵状血管瘤的CT和MRI诊断

目的总结7例鞍旁海绵状血管瘤CT、MRI和磁共振波谱（MRS）表现，探讨其诊断和鉴别诊断。资料与方法7例均经手术病理证实，均行CT和MR平扫，2例行CT增强扫描，7例行MR增强扫描，5例行MR扩散加权成像（DWI），6例行^1H MRS检查。结果鞍旁海绵状血管瘤体积大，并同时伸入到鞍内。CT平扫病变呈等或稍高密度，密度均匀，MR T1WI呈等或稍低于脑灰质信号，T2WI呈类似脑脊液高信号。增强扫描病变呈非常显著强化。DWI呈等或稍低信号，但表观扩散系数（ADC）值明显高于正常脑实质。。HMRS表现为NAA峰、Cr峰和Cho峰消失。可出现Lip峰。结论CT检查时鞍旁海绵状血管瘤与脑膜瘤和垂体瘤鉴别困难,MRI表现很有特点，T2WI呈极高信号，增强扫描非常显著强化，ADC值明显升高而DWI接近等信号，MRS检查无NAA峰、Cr峰和Cho峰，MRI可以对海绵窦海绵状血管瘤作出定性诊断。

CT and MRI Diagnosis of Juxtasellar Cavernous Hemangioma

Objective To analyze CT and MRI features of juxtasellar cavernous hemangioma, and to investigate its diagnosis and differential diagnosis. Materials and Methods 7 cases of juxtasellar cavernous hemangioma were all proved by operation and pathology. 7 cases were all examined by CT and MR plan scan, 2 cases were examined by CT enhancement scan, 7 cases were examined by MR enhancement scan, 5 cases by MR diffusion weighted imaging and 6 cases by MR proton spectroscopy. Restilts Juxtasellar cavernous hemangioma had big volume and extended to inner sella. There were homogenous isodensity or a little hyperdensity on CT plan scan. MR T1 image showed the signal intensity resembles or slightly hypointensity than ectocinerea. On MR T2 image, there was markedly hyperintensity resembles cerebrospinal fluid. In MR enhancement scan, the tumors enhanced remarkably. DWI showed isointensity or a little hypointensity, while the ADC value was distinctly higher than that in normal brain tissue. There were no NAA wave, Cr wave and Cho wave, but Lip wave appeared on MRS. Conclusion CT scan make difficult differential diagnosis among juxtasellar cavernous hemangioma, meningioma and pituitary tumor, MR images have some features. On MR T2 image, the signal intensity appears very high, it enhances remarkably. ADC value increase distinctly while DWI close to isointensity. MRS has no NAA wave, Cr and Cho wave. MR can make qualitative diagnosis of juxtasellar cavernous hemangioma.