垂体瘤质地的相关因素分析及其对治疗的影响

Correlative factors on consistency of pituitary adenoma and its therapeutic significance

目的分析术前预测垂体瘤质地的相关因素及其对治疗的影响。方法连续搜集60例垂体瘤病人的临床、影像及手术资料,将肿瘤质地分为三种类型:不成形,质地软;成形,质地软;成形、质地韧。结果本组中24例肿瘤不成形、质地软,大多呈膨胀性生长,且大多为类圆形;高功能性腺瘤多属此型。31例肿瘤成形、质地软,多呈浸润性生长,形状不规则。5例成型、质地韧,多为口服溴隐停病人及广泛浸润的巨大腺瘤。三种质地肿瘤的M RI信号变化较大,未发现规律。结论肿瘤质地与肿瘤的生长方式存在内在联系,膨胀性生长者质地多软且不成形,手术可经鼻蝶入路进行。依据M RI不能很好地预测肿瘤质地。

Objective To explore the correlative factors on consistency of pituitary adenomas. Methods Clinical, unage and surgical data ot 60 patients were collected. According to the data, the tumors were divided into three types： formless and soft, shaped and soft, and shaped and solid. Results Twenty-four adenomas were soft and formless, and most of them were roughly round in shape and tended to expanding growth, and many of them belonged to functioning adenomas. Thirty-one adenomas were soft and shaped, most showed invasive growth and irregular-shape. Five adenomas were shaped and solid, most of which were gigantic invasive tumors in the patients taking oral bromocriptine. MRI signals had various changes, and no regularity was found. Conclusions The consistency of pituitary adenomas has an intrinsic relationship to the growth manner of tumors. The expanding-growth type adenomas are soft and formless and can be resected via transsphenoidal approach. The consistency of pituitary adenomas can not be predicted perfectly by MRI signals.