颅咽管瘤的影像学表现与临床病理分析

CRANIOPHARYNGIOMA IMAGING FINDINGS AND ITS CLINICAL PATHOLOGY ANALYSIS

目的回顾性总结22例颅咽管瘤与鞍区肿瘤的影像学表现与临床病理,旨在提高对其影像学诊断水平。方法选取2008—2014年病例22例。MR、CT、X线头颅正侧位平片检查分别为18例、15例、10例。手术及临床放射治疗共18例。分析MR、CT、X线诊断的病理符合率。结果 22例患者中经手术及临床放疗证实颅咽管瘤14例。MR诊断符合率71.4%;CT诊断符合率61.5%;X线诊断符合率30%。结论颅咽管瘤的影像学表现呈多种形态。MR对显示病变的范围、大小,尤其是矢状位能显示微小肿瘤明显优于CT、X线。但MR显示钙化不如CT及X线。颅咽管瘤应与鞍区其他病变鉴别。仅从病变部位、形态或单一检查做出准确诊断较困难,增强扫描十分重要,尤其对实性病变的诊断与鉴别诊断有较大的帮助。颅咽管瘤特征性影像学表现,为颅咽管瘤的诊断和鉴别诊断提供了重要信息,并与临床病理具有良好的相关性,结合患者临床资料可进一步提高诊断正确率。

Objective To retrospectively sum up imaging findings and clinical pathology craniopharyngioma with sellar tumors of 22 cases,aimed at improving its radiological diagnosis.Methods Twenty-two cases corresponding to diagnosis standards were chosen in author＇s hospital between 2008 to 2014.The patients with MR,CT,X-ray head lateral plain film examination were 18,15 and 10 cases respectively.Eighteenof them were treated with surgery and clinical radiotherapy.The consistent rate of MR,CT,X-ray diagnosis with pathology were analyzed.Results Totally 14 of 22 patients were confirmed craniopharyngiomas by clinical radiotherapy after surgery.The diagnostic coincidence rates were 71.4%,61.5% and 30% of MR,CT and X-ray respectively.Conclusions Craniopharyngioma imaging shows a variety of forms.MR is significantly better than CT,X-ray on displaying lesion range,size,especially in the sagittal potential small tumors,but not as good as CT and X-ray on showing calcification.Craniopharyngioma and other sellar lesions should be identified.Only lesion,shape or single check to make an accurate diagnosis was more difficult,an enhanced scan is very important,especially in the diagnosis and differential diagnosis of solid lesions.Characteristic radiologic manifestation can provide important information on diagnosis and differential diagnosis of craniopharyngioma,and has a good correlation with clinical pathology.Clinical data of patients can further improve diagnostic accuracy.