鞍区囊性病变的MRI诊断和鉴别诊断

目的探讨鞍区囊性病变的MRI表现,以提高诊断和鉴别诊断水平。方法回顾性分析43例经手术病理及临床随访证实的鞍区囊性病变,包括17例垂体腺瘤囊变、10例Rathke囊肿、4例囊性颅咽管瘤、3例垂体脓肿、9例空泡蝶鞍,所有病例均行MRI平扫,30例行增强扫描。结果囊性垂体腺瘤主要表现为长T_1长T_2信号,14例有囊壁环形强化;Rathke囊肿、颅咽管瘤、垂体脓肿信号多样,与囊内容物有关;空泡蝶鞍表现为长T_1、长T_2信号,且漏斗无移位。结论鞍区囊性病变的临床和MRI表现特点对术前诊断和鉴别诊断有一定价值。

MRI diagnosis of cystic lesions in the sellar region

Objective To evaluate the MRI manifestations of cystic lesions in the sellar region （SRCL）. Methods MRI of 43 cases of SRCL confirmed by histology or clinical follow-up was analyzed retrospectively. The lesions included cystic pituitary adenomas （n=17）, Rathke＇s cysts （n= 10）, craniopharyngiomas （n=4）, pituitary abscess （n=3）, and empty sella （n=9）. Results Cystic pituitary adenomas were hypointense on T1WI and hyperintense on T2WI with 14/17 cases showing contrast enhancement of the cyst wall. Rathke＇ s cysts, craniopharyngiomas and pituitary abscesses demonstrated varying signal intensities on T1WI and T2WI depending on the cyst content. The cerebrospinal fluid in empty sella was T1-hypointense and T2-hyperintense without displacement of the infundibulum. Conclusion MRI findings of SRCL are helpful for differential diagnosis.