鞍区动脉瘤1例报告并文献复习

Aneurysms of Sellar Region: One Case Report and Literature Review

目的 :探讨鞍区动脉瘤的临床表现、影像学特点及鉴别诊断。方法 :分析 1例鞍区动脉瘤并复习文献。结果 :术前诊断考虑为垂体腺瘤 ,术中发现为动脉瘤 ,术后 DSA确诊。该患者有内分泌障碍 ,主要表现垂体功能减退 ,高泌乳素血症 ;有视力障碍和视野缺损 ;CT显示鞍区类圆形占位 ;手术治疗。结论 :鞍区动脉瘤术前诊断困难 ,易与垂体腺瘤混淆。对于鞍区占位 ,如有下列情况 ,应考虑动脉瘤的可能 :1病史中有 SAH史 ;2单侧视野缺损 ;3一侧 、 或 颅神经麻痹 ;4影像学表现鞍区类圆形病变 ,CT有钙化 ,MRI有流空现象 ;5内分泌紊乱呈垂体功能减退 ,高泌乳素血症者。确诊依靠 DSA。治疗以手术和介入治疗为主。

Objective:To investigate clinical manifestation, CT and MRI findings and differential diagnosis of aneurysms of sellar region.Methods:Three cases of aneurysms of sellar region were analysed and literature was reviewed.Results:The diagnosis of the case was considered as pituitary adenoma before operation. The correct diagnosis was made during surgical exploration, and was further determined by digital subtraction angiography (DSA) postoperation. This case had endocrine disturbances, such as hypopituitarism and hyperprolactinemia, and visual disturbance and visual field defects. There was a round-like mass at sellar region on CT scan. The patient underwent surgical operation.Conclusions:It was difficult to diagnose aneurysms of sellar region preoperation and easy to be mistaken by pituitary adenoma. For patients with mass of sellar region , aneurysms should be considered if patients had some presentations as follows:① a history of SAH;②unilateral visual field defects;③ unilateral ⅢⅣ or Ⅵ cranial nerve paralysis;④image indicating a round-like mass of sellar region, calcification on CT scan, flowing void phenomenon on MR images;⑤endocrine disturbances such as hypopituitarism and hyperprolactinemia. The diagnosis depends on DSA. Treatment mainly includes surgical operation and interventional therapy.