中枢性尿崩症的MRI诊断

MRI Diagnosis of Central Diabetes Insipidus

目的评价MRI对中枢性尿崩症的诊断价值,探讨中枢性尿崩症的发病机理。资料与方法搜集临床诊断为中枢性尿崩症患者19例,回顾性分析其MRI表现,推断发病机理。结果19例中下丘脑胶质瘤5例,颅咽管瘤4例,生殖细胞瘤4例,产后尿崩症2例,病理诊断不明4例。全部病例均表现有垂体后叶高信号消失及鞍区相应其他异常改变。2例生殖细胞瘤、1例胶质瘤和1例颅咽管瘤经治疗后尿崩症症状缓解或消失,9例治疗后复查MRI可见垂体后叶高信号影。结论MRI对大部分引起中枢性尿崩症的鞍区病变能够做出定性诊断,有助于证实药物治疗效果。

Objective To evaluate MRI diagnostic value in central diabetes insipidus, and discuss its pathogenesis. Materials and Methods The MR findings of 19 cases with central diabetes insipidus diagnosed by clinical were analyzed retrospectively, and the pathogenesis was discussed. Results In 19 cases, hypothalamus gliomas （ n = 5 ）, craniopharyngiomas （ n = 4）, germinomas （ n = 4）, postpartum diabetes insipidus （ n = 2） ; the other 4 cases were with uncertain pathological diagnosis. The hyperintensity （HIS） of posterior pituitary was absent in all the cases with abnormal appearance of sella turcica region. Symptom of insipidus releived or disappeared in 2 cases of germinimas, 1 case of glioma and craniopharyngiomas respectively, and also HIS of posterior pituitary was found on MR images in 9 cases after treatment. Conclusion Abnormal appearances of sella turcica which led to central diabetes insipidus can be diagnosed on MR images. MRI is helpful to evaluate effects of clinical therapy.