原发性垂体前叶功能低下症原因的MRI诊断

MR Diagnosis of Primary Pituitary Hypofunction

目的 :分析原发性垂体前叶功能低下症的MR影像特点 ,以明确其病因。材料与方法 :经临床 ,实验室及MR确诊的原发性垂体前叶功能低下症共 2 1例。均行MR平扫及增强检查。结果 :垂体大腺瘤共 9例 (女 3例 ,男 6例 ) ,5例合并腺瘤出血。继发性空蝶鞍 8例 ,均为女性 ,其中 5例继发于微腺瘤术后 ,1例继发于腺瘤γ刀治疗后 ,2例继发于产后大出血。垂体低矮共 3例 (1例为儿童 ,2例为成年女性 )。垂体影像正常 1例。结论 :原发性垂体前叶功能低下症的常见病是垂体大腺瘤和继发性空蝶鞍 ,MRI能为明确病因提供可靠的影像学证据。

Purpose: To assess MRI features of the primary pituitary hypofuction (PPH) and analyze the usual causes of PPH. Materials and Methods: MRI findings of 21 cases of PPH proved by clinical and MRI diagnosis were retrospectively analyzed. The 21 cases underwent both contrast enhanced and plain MRI scans. Results: (1) There were 9 cases of pituitary macroadenomas, 5 cases of which had hemorrhage in the ademomas. (2) 8 cases were secondary empty sella, 5 cases of which were after microadenomas operation. 1 cases had received γ knife therapy of pituitary adenomas. 2 cases were secondary to sheehan's syndrome. (3) 3 cases showed small sell turcia, small anterior lobe and hypoplasia of the pituitary stalk. (4) 1 case showed normal pituitary. Conclusion: The usual causes of PPH are pituitary macroadenoma (often with hemorrahage in the foci), the other usual cause of PPH are secondary empty sella which mainly occurs in female patients. MRI examination makes it possible to determine the causes. It can play a significant role in clinical diagnosis of PPH.