磁共振成像诊断海绵窦侵袭型垂体瘤(附39例报告)

Diagnosis of invasion hypophysoma by MRI (report of 39 cases)

目的 建立一套海绵窦侵袭型垂体瘤的MRI诊断系统。方法选取确诊的39例海绵窦侵袭型垂体瘤与同期收治的162例非侵袭型垂体瘤进行对照,分析冠状位MRI图像上肿瘤与海绵窦的关系,包括海绵窦形态的改变、窦内间隙的改变,以及肿瘤与颈内动脉海绵窦段的关系等,将相关的各个类型作为拟诊标准,计算各自的灵敏度(Se)、特异度(Sp)、阳性预告值(PV+)、阴性预告值(PV-)。结果肿瘤包绕颈内动脉≥70％确诊侵袭的意义最大(PV+为100％),肿瘤超过颈内动脉外侧连线的诊断意义也较高(PV+为86.1％);如果肿瘤包绕颈内动脉<20％、肿瘤未超过颈内动脉内侧连线及海绵窦内侧间隙未出现肿瘤,则可排除海绵窦侵袭的存在。结论 系统分析垂体瘤MRI图像的表现,能较准确地诊断海绵窦侵袭型垂体瘤。

Objective To define the value of magnetic resonance imaging (MRI) on invasive hypophysoma in cavernous sinus. Methods The coronary MRI of sellar region obtained in 201 patients with hypophysoma and dealt with computer were reviewed retrospectively. The tumor's involvement in cavernous sinus was analyzed systematically with computer in several groups. Based on them, the valuable factors for diagnosing the invasion of cavernous sinus and surged to approach the efficacy of MRI with discriminant analysis were aaquired. Results If the encasement of the hypophysoma was not less than 70%,it could ensure the invasion of cavernous sinus accurately. If the encasement was less than 20%, the tumor was not depictured in the medial venous compartment,or the tumor was not crossed the medial intercarotid line,the diagnosis of cavernous sinus invasion should be given up. Conclusion The diagnosis of invasive hypophysoma can be setted up by analysising of coronary MRI.