鞍区占位性病变垂体后叶磁共振高信号影的研究

Study of high signal intensity of the posterior pituitary on magnetic resonance imaging in patients with space occupying lesion in sellar region

目的 观察鞍区占位性病变患者垂体后叶的磁共振高信号影的改变.方法 回顾性纳入南京军区福州总医院神经外科2012年12月至2014年12月连续收治的经手术和病理学证实的鞍区占位性病变患者189例（垂体腺瘤123例、颅咽管瘤26例、Rathke囊肿22例、鞍结节脑膜瘤18例）.分析MRI显示不同病变垂体后叶亮点（PPBS）的出现情况及位置.结果 189例中,119例（63.0％）出现PPBS,其中垂体腺瘤患者的出现率为79.7％ （98/123）,颅咽管瘤为3.8％ （1/26）,Rathke囊肿为9.1％ （2/22）,鞍结节脑膜瘤为100％ （18/18）,不同病变患者PPBS的出现率差异有统计学意义（P＜0.01）;垂体腺瘤患者PPBS可位于鞍内（35例）、鞍上（48例）及鞍内-鞍上（15例）,而颅咽管瘤、Rathke囊肿、鞍结节脑膜瘤的PPBS均位于鞍内.结论 鞍区占位性病变患者PPBS出现率和位置有差异,可能有助于不同病变的鉴别.

Objective To observe the changes of high signal intensity of the posterior pituitary on magnetic resonance imaging in patients with space occupying lesion in sellar region. Methods From December 2012 to December 2014, 189 consecutive patients （pituitary adenoma 123, craniopharyngioma 26, Rathke cyst 22, and saddle nodules meningioma 18 ） with space occupying lesion in the sellar region admitted to Fuzhou General Hospital of Nanjing Military command and confirmed by pathology were enrolled retrospectively. MRI images and pathological analysis were conducted. The occurrence of posterior pituitary bright spot （PPBS） of different lesions and their positions were analyzed. Results In 189 patients, 119 （63%） occurred PPBS. The occurrence rate of PPBS in patients with pituitary adenoma was 79. 7% （98/123）, that of craniopharyngioma was 3.8% （1/26）, Rathke＇s cleft cyst was 9. 1% （2/22）, and tuberculum sellae meningioma was 100% （18/18）. There were significant differences in the occurrence rate of PPBS in patients with different lesions （P 〈 0.01 ）. PPBS could be located inside the sella （n = 35）, outside the sella （n =48）, or inside and outside the sella （n = 15） in patients with pituitary adenoma. The PPBSs of the latter three located in the sellae. Conclusions There are differences in the occurrence rate and location of PPBS in patients with space occupying lesions in the sellar region. They may be helpful in the identification of different lesions.