MRI对垂体腺瘤质地术前评估的研究进展

Research progress of MRI in preoperative evaluation of pituitary adenoma’s consistency

垂体腺瘤是成人原发于垂体窝最常见的病变,是颅内第三大原发性肿瘤。对于可切除的垂体腺瘤病灶,临床上通常采用两种方法:内镜下经蝶窦切除和开颅切除,具体选用何种手术方式与肿瘤的大小、侵犯程度以及质地有密切的关系。对于较为柔软、易于牵拉的肿瘤可选择内镜下经蝶窦切除;对于质地较硬的垂体腺瘤,开颅手术更为适合。若术前能预先判断肿瘤质地,将便于手术方案选择,达到更好的治疗效果。颅脑MR成像对于脑组织有较高的分辨能力,不仅可应用于颅脑疾病的诊断,也可用于判断肿瘤质地。回顾性阐述垂体腺瘤不同质地的形成机制以及应用鞍区MR成像技术进行肿瘤质地术前评估的研究进展。

As the most common primary disease in pituitary fossa, the incidence of pituitary adenoma ranks 3rd in the primary tumors of the brain. To remove those resectable pituitary adenomas, there are 2 surgical approaches, named trans- sphenoidal endoscopic surgery and craniotomy. Which approach should be used depends on the size, invasive extension and the consistency of the tumors. The trans-sphenoidal endoscopic surgery is more suitable for the tumors with soft consistency which are easy to pull out, while the craniotomy is suitable for the hard ones. So, preoperative evaluation of the tumors＇ consistency can help to find the best surgical approach and treatments. MRI is not only an ideal method to show the structure of brain, but also can be used to evaluate consistency of tumor. This review illustrated the forming mechanism of the different consistency of pituitary adenoma and the research process in evaluating the consistency.