颅咽管瘤的MRI表现及病理分析

Study of MR manifestations and pathology of craniopharyngioma

目的:分析颅咽管瘤的MRI及病理表现,探讨MRI对颅咽管瘤的诊断价值。方法:回顾性分析56例术前颅脑MRI平扫及增强扫描并经手术病理证实为颅咽管瘤的病例资料,分析其MRI及相关病理表现。结果:颅咽管瘤发生于鞍上20例,鞍内及鞍上30例,鞍内2例,鞍旁2例,桥前池1例,颞顶叶1例。病变囊性25例,囊实性26例,实性5例。囊性部分多呈长T1、长T2信号,实性部分多表现为等T1、等T2信号;Gd-DTPA增强扫描后,囊性部分的囊壁多呈弧形或环形强化,实性部分不均匀明显强化。17例有详细的病理资料,其中成釉质细胞型颅咽管瘤13例,鳞状乳头型颅咽管瘤2例,混合型颅咽管瘤2例。结论:颅咽管瘤的MRI表现具有一定的特点,其信号特征多样性与其病理成分具有一定的相关性,MRI具有很高的诊断和鉴别诊断价值。

Objective：To study the MR images and pathology of craniopharyngioma and explore the value of MRI in diagnosis.Methods：Fifty-six patients were examined with MRI before surgery.The MR manifestations and relative pathology materials were analyzed retrospectively.Results：There were 20 cases of craniopharyngioma located in suprasellar region,30 cases both in sella and superasellar region,2 cases in sella,2 cases in parasellar region,1 case in anterior pontine cistern and 1 case in temporal-parietal lobe.Twenty-five cases of craniopharyngioma were cystic,26 cases were solid-cystic and 5 cases were solid.The cystic part was often hypointense on T1WI and hyperintense on T2WI and the solid part was of iso-intense on T1WI and T2WI.The wall of the cystic part presented curvilinear or circular enhancement and the solid part pre-sented nonhomogeneous enhancement after contrast administration.Seventeen cases had detailed pathological information,of which 13 cases were the adamantinous craniopharyngioma,2 cases the papillary squamous type and 2 cases the mixed type.Conclusion：The MRI manifestations of craniopharygioma are characteristic,and the MR signal may be well related to its pathological type.MRI is an effective way to make diagnosis of craniopharyngioma as well as differential diagnosis.