垂体脓肿的MRI诊断及鉴别诊断

目的探讨垂体脓肿的MRI诊断与鉴别诊断和临床特点。方法回顾性分析6例经手术病理证实的垂体脓肿的MRI表现,所有患者术前均行MR平扫和增强。结果6例均表现为垂体腺增大,向鞍上突出;5例MR平扫T1WI呈低信号,1例呈等信号;4例T2WI呈脑脊液样高信号,2例呈稍高信号;MR增强扫描均呈环形强化,且环壁薄而均匀,部分环壁稍厚。结论平扫T1WI呈低或等信号、T2WI呈脑脊液样高信号或稍高信号及增强呈环形强化是垂体脓肿的主要MR表现。

Objective To investigate MRI diagnosis and differential diagnosis and clinical features of the pituitary abscess.Methods We retrospectively analyzed MRI manifestations of six pituitary abscess which was pathologically conf irmed by surgery,all cases were examined by MR plan scan and MR contrast scan before operation.Results 6 cases showed enlargement of pituitary gland,sticking out to suprasellar.5 cases showed hypointensity on MR T1WI and 1 cases appeared equal signal on MR T1WI：4 cases showed hyperintensity which resembled cerebrospinal fluid-like on MR T2WI,2 cases showed a little hyperintensity on MR T2WI.All cases showed ring-like enhancement in MR contrast scan.The thickness of the ring wall showed thin and even in all cases,partly cases with very thick ring wall.Conclusion Low or equal signal in MR plan scan T1WI,high signal cerebrospinal fluid-like or slightly high signal in T2WI,ring-like enhancement in MR contrast scan is the main MR manifestations of the pituitary abscess.