垂体脓肿的MRI诊断及其临床意义

MRI diagnosis of pituitary abscess and its clinical significance

目的总结垂体脓肿的 MRI 特征。方法回顾性总结经手术、病理和临床证实的14例垂体脓肿患者的 MR 平扫和增强表现,分析其影像特征。结果12例患者 MR 平扫示鞍区囊性改变,T_1WI 呈不均匀低信号,2例 T_1WI 呈等及稍高信号。14例患者 T_2WI 均呈高信号改变。增强后 T_1WI 均表现为不均匀的边缘环形强化及与病灶相连的周围脑膜强化,正常垂体未能显示。MRI特征性表现为液一液平面、壁结节、强化的絮状阴影。结论垂体脓肿的 MRI 有其特征性,结合临床术前可以作出诊断,从而指导临床治疗方法的选择。

Objective To investigate the MR features of pituitary abscess. Methods The MR features of 14 cases of pituitary abscess proved by surgical pathology and clinical treatments were analyzed retrospectively. Results Pre-contrast MR showed hypointense heterogeneous intensity on T1WI in 12 cases and iso-hyperintense on T1WI in 2 cases, hyperintense on T2WI in all cases. Post-gadolinium MR showed the ring-like enhancement around the uneven edge of abscess and the surrounding enhanced meninges connecting to the focus. The normal pituitary could not be identified in all 14 cases. The MR specific findings include the fluid-fluid level, nodule on the edge and the enhanced patchy shadow. Conclusions The pituitary abscess has specific findings on MR examination, which can be used to combine with clinical symptoms to achieve the diagnosis before operation, so that the cases could be treated with antibiotic without operation.