MRI对原发性空蝶鞍综合征的诊断价值

MR imaging of primary empty sella syndrome

目的探讨磁共振成像(m agnetic resonance im aging,MR I)对原发性空蝶鞍综合征的诊断价值。方法对有头颅MR I检查并有完整临床资料的原发性空蝶鞍患者36例进行研究。采用矢状面T1W I、冠状面T1W I,横断面T1W I、T2W I,9例行钆对比增强扫描。结果原发性空蝶鞍综合征患者蝶鞍的MR I表现主要有鞍区增大、鞍底下陷、鞍内为典型的长T1、长T2脑脊液信号;垂体受压变扁紧贴于鞍底,受压垂体信号无异常改变,垂体柄延长直达鞍底。其临床表现主要有:顽固性头痛、头晕、视力障碍、内分泌紊乱等症状。结论原发性空蝶鞍综合征具有典型的MR I表现,MR I可清晰显示空蝶鞍,MR I应作为原发性空蝶鞍综合征的首选影像学检查方法。

Objective To explore the diagnostic value of MR imaging of primary empty sella syndrome （PESS）. Methods Totally 36 patients, 9 male and 27 female, with PESS undertook cerebral MR imaging. Sagittal and coronal T1-weighted images, axial T1 and T2-weighted images were obtained in all cases, and contrast enhanced MR scanning with Gd-DTPA was carried out in 6 patients. Results MRI features of PESS were as follows： The sella expanded; The inside of sella expressed CSF signal; The pituitary was compressed to become flat and close to the bottom of the saddle ; The signal of pituitary was of no change ; The hypophysis handle generally had elongated. Conclusion PESS has typical MR manifestations that show empty sella clearly. MRI should be regarded as the best way to diagnose PESS.