颅咽管瘤的CT表现特征分析

Analysis of CT Findings of Craniopharyngioma

目的：通过对６２例经手术病理证实为颅咽管瘤病人的ＣＴ表现进行分析，观察总结本病在ＣＴ上的特征性及非特征性表现，并与有关疾病进行鉴别。材料与方法：６２例受检病人男性３６例、女性２６例，临床表现有头晕、头痛、视力改变等，病程大多在半年至１年左右。ＣＴ扫描采用平行于ＯＭ线及冠状扫描，平扫加增强。结果：鞍上区发病者占８５．４８％，病变仅限于鞍区者占１４．５２％，病灶直径为２．０～８．０ｃｍ，病灶与周围组织结构清楚者占６２．２９％，一般呈等、低密度（占９６．７１％），具有钙化者７７．７４％，囊变发生率为７２．５８％，经增强扫描６７．７４％的病人病灶呈环状强化。结论：病灶发生于鞍上区，伴有钙化、囊变、呈环状强化是颅咽管瘤的特征性ＣＴ表现；但该病也会存在不典型表现，如病灶发生于鞍区及钙化不典型或无钙化，以及呈现囊性病灶，因此需与垂体瘤、胆脂瘤、脑膜瘤等疾病进行鉴别。

Purpose:Through the analysis of 62 cases of craniopharyngioma proved by operation and pathology, the Specific and non-Specific CT findings Were observed and summarized. The disease was differentiated from the other relative diseases. Materials and methods: 62 patients(male 36 cases, female 26 cases)had a history of dizzeness, headache,change of vision and so on. The clinical course was mostly from half to one year. Axial scanning parallel to OM line and coronary scanning were performed before and after contrast enhancement. Results:The disease was located in the suprasellar area by 85. 48%and only in sellar area by 14. 52%. The diameter of the lesion was from 2. 0 to 8.0cm. There was a sharp margin between the lesion and surrounding tissue in 39 cases(62. 29%). The lesion showed isodensity or hypodensity in 96. 76%of the patients,accompanied with calcification in 77. 76%of the patients and cystic change in 72. 58%. The lesion in 67. 74%of patients showed ringlike enhancement after contrast injection. Conclusion: The location of the suprasellar area, calcification,cystic change and ringlike enhancement of the lesion were the specific CT findings of craniopharyngioma.It should be differentiated from pituitary tumor,cholesteatoma,meningioma and others when the lesion located in the sellar area and was not accompanied with calcifications or cystic changes.