MRI诊断原发性空蝶鞍综合征

MR Imaging of Primary Empty Sella Syndrome

目的 :分析原发性空蝶鞍综合征的 MRI影像表现 ,探讨 MRI对原发性空蝶鞍综合征的诊断价值。方法 :2 0 0 2年 1月至 2 0 0 4年 6月对 2 1例临床有症状的原发性空蝶鞍患者行颅脑 MRI检查 ,基本扫描序列为矢状面T1 WI、冠状面 T1 WI,部分病例加横断面 T1 WI、T2 WI、Flair,6例行钆对比增强扫描。结果 :原发性空蝶鞍综合征的MRI表现主要有蝶鞍增大 ,鞍底下陷 ,鞍内见典型的长 T1 、长 T2 脑脊液信号 ,垂体受压变扁紧贴于鞍底 ,冠状位呈锚状而矢状位呈线状 ,但其信号无异常改变 ,垂体柄一般无偏移。结论 :原发性空蝶鞍综合征具有典型的 MRI表现 ,MRI可准确诊断 PESS,并可鉴别原发性空蝶鞍与其他病变 ,应作为 PESS的首选影像学检查方法。

Objective To analyze MR imaging features of primary empty sella syndrome(PESS) and explore diagnostic value of MR imaging in PESS.Methods Twenty-one patients (6 male,15 female) with PESS undertook cerebral MR imaging on a 1.5 T scanner (GE Signa) from January 2002 to June 2004. Sagittal and coronal T 1-weighted images were obtained in all cases, while axial T 1-and T 2-weighted images, Flair images were obtained in some cases,and contrast-enhanced MR scanning with Gd-DTPA were carried out in six patients.Results MRI features of PESS were as follows:①the sella expanded;②the inside of sella was expressed with CSF signal;③pituitary gland was pressed and flat closed to the bottom,it showed line shape on sagittal scan and anchor shape on coronal scan;④pituitary handle was placed in the middle and extended.Conclusion PESS has similar MRI manifestations. MRI could reveal the correct diagnosis with its multi-oriented characteristics, and it is recommendable as the first choice of imaging procedure in PESS.