不典型Rathke裂囊肿的MRI诊断

MRI diagnosis of atypical Rathke cleft cyst

目的:探讨不典型Rathke裂囊肿的MRI特征性表现及鉴别诊断。方法:回顾性分析经病理证实的Rathke裂囊肿28例,其中18例影像学表现不典型,总结其部位、信号、囊壁、胶样小体及强化方式的的诊断价值。结果:11例病变位于鞍内,17例位于鞍内及鞍上,呈圆形或类圆形,边界清楚;囊内容物信号表现多样,其中等T1长T2信号3例,短T1长T2信号7例,短T1短T2信号5例,短T1等T2信号1例,混杂T1、T2信号2例;囊内可见漂浮结节者6例;垂体窝内可见受压的正常垂体组织者16例。增强MRI:4例无强化,10例可见囊壁周围区域呈断续的线样强化。结论:MRI平扫能够清楚显示病变,但对于不典型Rathke裂囊肿的的诊断有一定的局限性;增强MRI有利于同鞍区其它病变的鉴别诊断。

Objective： To investigate MR findings and differential diagnosis of Rathke cleft cyst. Methods： MR findings of 28 Rathke cleft cysts confirmed by pathology were retrospectively studied . 18 of which have atypical MRI apperances. To analyze the lesions location,signal intensity,cyst wall, cyst corpuscle and the style of MRI enhancement.Results：The lesions were round or oval in shape with clear border. 11 cysts were located intrasellarly, and 17 were located both intrasellarly and suprasellarly. MRI signals varies ,16 could see the compressed pituitary intrasellar. Among the 14 patients who underwent contrast enhancement,4 showed no enhancement, and 10 were enhanced uncontinuous peripherally. Concluslon：Plain MRI could describe the lesions clearly, but limited to the diagnosis of the atypical ones;enhanced MRI maybe helpful to the differential diagnosis from the other lesions of the sellar region.