中枢性尿崩症的脑部MRI表现（附27例报告）

MRI of Brain in Patients with Central Diabetes Insipidus

目的：探讨中枢性尿崩症（ｃｅｎｔｒａｌｄｉａｂｅｔｅｓｉｎｓｉｐｉｄｕｓ，ＤＩ）的脑部ＭＲＩ诊断及相关性问题。材料与方法：报道２７例ＤＩ患者的ＭＲＩ所见，９例通过手术证实，５例作过Ｇｄ－ＤＴＰＡ增强扫描，均采用ＳＥ系列，对ＤＩ的成因及其与脑ＭＲＩ的相关性进行探讨。结果：２７例中，９例表现正常及空蝶鞍，其余病变均累及下丘脑－垂体系统，其中肿瘤（垂体腺瘤，颅咽管瘤，生殖细胞瘤）１０例，单纯垂体后叶高信号消失５例，合并垂体后叶高信号消失１２例，鞍区手术２例，组织细胞病Ｘ１例。结论：中枢性尿崩症病因复杂多样，最常见于垂体腺瘤，颅咽管瘤，生殖细胞瘤，鞍区术后。后叶高信号消失对ＤＩ的诊断具有特征性价值，对ＤＩ患者的影像学检查，ＭＲＩ应放在首位。

To discuss MRI appearence of brain in patients with central diabetes insipidus(DI) and its relationship.Materials and Methods: MRI findings of brain in 27 patients with central DI were reported,9 cases were confirmed by surgery and clinical findings,5 cases had contrast enhance,We studied the cause of DI and the relationship between DI and MRI manifestation.Results:Of the 27 cases reviewed,9 cases were normal.Other lesions had involved the hypothalamic neurohypophyseal axis.There were tumors(pituitary adenoma,craniopharyngioma,germinoma.n=10).Absence of hyperintensity in the posterier lobe (n=17),sellar surgery(n=2),histiocytosis X(n=1).Conclusion:Central DI could resulted from a wide variety of diseases. the most common cause of DI appear to be tumor and surgery.The absence of hyperintensity in the posterier lobe could provide characteristic basis for the diagnosis of the central DI.MRI is the imaging method of choice in patients with central DI.