中枢性尿崩症临床分析及垂体磁共振成像特点

Clinical Analysis and MRI characteristics of patients with Central Diabetes Insipidus

目的观察尿崩症的临床特点及磁共振成像表现,评估磁共振对中枢性尿崩症病因诊断的价值。方法对74例经禁水-垂体加压素试验证实为尿崩症患者的发病年龄、病因、临床表现及影像学、垂体前叶功能进行分析。结果10岁及在40岁左右是发病的高峰年龄段;各类尿崩症中枢性尿崩症72例(占97.3%),肾性1例(1.35%),精神性1例(1.35%);中枢性尿崩症中特发性51.39%,颅脑外伤2.78%,颅内肿瘤38.89%,希恩综合征2.78%,颅脑感染1.39%,垂体术后继发2.78%;61例进行垂体磁共振检查患者显示23例单纯垂体后叶高信号消失(37.7%),28例垂体柄病变(45.9%)。结论中枢性尿崩症患者中以特发性居多,垂体MR I有助中枢性尿崩症的病因诊断。

Objective To explore the etiology,clinical and MRI characteristics of central diabetes insipidus （CDI）. Methods The clinical data of 72 eases with diabetes insipidus admitted to the Anhui Provincial Hospital between 2001 and 2008 were analyzed retrospectively. Results Most of the cases among children and youngsters fell ill at the age of 8 - 12 years,while most of the adult cases fell ill at the age of 30 - 45 years. The morbidities of CDI, nephrogenic and primary polydipsia were 97.3%, 1.35 % and 1.35 % ,respectively. Meanwhile ,the causes of CDI in this study included idiopathic CDI 51.39% ,head trauma 2.78% ,neoplasm 38.89% ,Sheehan syndrome 2.78% ,infections 1.39% and postoperation 2.78%. Pituitary MRI showed the absence of high signal normally seen in posterior lobe （37.7%） and thickened pituitary stalk （45.6%）. Conclusion Central diabetes insipidus is common and mostly idiopathic. Pituitary MRI can provide useful information for the etiological diagnosis of CDI.