Rathke囊肿的影像学诊断与鉴别诊断

Imaging diagnosis and differential diagnosis of Rathke's cleft cyst

目的:分析Rathke囊肿的CT和MRI表现,提高对该病的诊断水平。方法:回顾性分析经手术与病理证实的14例Rathke囊肿的CT及MRI资料。结果:14例Rathke囊肿,CT平扫8例,其中4例为低密度,2例等密度,1例高密度,1例囊壁可见钙化。3例CT增强扫描未见明显强化。MRI平扫主要显示为圆形或类圆形,5例位于鞍内,9例位于鞍内及鞍上。6例为长T1、长T2信号,5例为短T1、长T2信号,2例为短T1、短T2信号,1例信号不均匀。12例MRI增强扫描,其中10例未见明显强化,2例囊壁轻度强化。结论:Rathke囊肿囊液密度/信号变化多样,通过总结其影像特点并结合详细的影像学检查可对其中多数病例做出正确的定性诊断。

Objective： To analyze CT and MRI findings of Rathke＇s cleft cyst and enhance the level of diagnosis for this diseases. Methods： CT and MR imaging findings in 14 patients with pathologically proved Rathke＇s cleft cyst were collected. Results： Among the 14 patients,4 cases showed low density and 2 cases demonstrated iso-density and 1 case displayed high density on plain CT scan. Only one case presented with calcification on the wall of the cysts. On plain MR scan,most of the Rathke＇s cleft cysts were round or oval in shape with clear border,5 cysts were located intrasellarly and 9 were located both intrasellarly and suprasellarly. MRI signals showed long T, and long T2 in 6 cases,short T1 and long T2 in 5 cases,short T1 and short T2 in 2 cases,heterogenuous T1 and T2 in 1 cases. On post-contrast MRI scan, the wall of the cysts showed,no enhancement in 10 cases and enhanced peripherally in 2 cases. Conclusion： CT density and MRI signal intensity were various for Rathke＇s cysts according to the component of cysts. It is possible to make accuracy diagnosis in majority of this disease through analysing CT and MRI features of Rathke＇s cleft cyst as well as detailed imaging examinations.