磁共振T2WI对垂体腺瘤质地的评估

MRI evaluation of pituitary macroadenomas tumor consistency

目的探讨垂体瘤术前MRI信号特征及其与垂体瘤质地的关系。材料与方法对120例垂体瘤患者依术中所见质地进行分类,比较不同质地组间患者年龄、最大径、T2WI肿瘤/脑白质信号的比值,分析其手术方式和切除程度的差异。结果非实性垂体瘤13例,12例质地软,所有非实性垂体瘤均经蝶入路手术,全部为全切或次全切。实性垂体瘤共107例,质软组70例、质韧组30例及混合组7例,质软组肿瘤T2WI信号比显著高于质韧组和混合组(P=0.005、0.000)。质软组切除程度显著高于质韧组(χ~2=14.13,P=0.003)。结论垂体瘤T2WI肿瘤/脑白质信号的比值与其质地和手术方式及切除程度密切相关,可在术前准确判定肿瘤质地,为手术入路的选择提供影像学依据。

Objective： To assess the role of the preoperative MR signal in predicting the tumor consistency of pituitary macroadenomas. Materials and Methods： According to the surgical findings, 120 pituitary macroadenomas were divided into three types： hard, soft and mixed type. Patient＇s age, maximum diameter of tumor, the ratios of signal intensity of tumor to the white matter of temporal lobe in solid tumors were compared in different types. Surgical approach and resection degree in three types tumors were analyzed comparatively. Categorical variables were examined with the chi-square; continuous-scale data were analyzed with the analysis of variance. Results： 12 of 13 non-solid tumors were soft. All non-solid tumors received total or subtotal transsphenoidal hypophysectomy. In 107 solid tumors, the ratios of T2-weighted signal intensity of tumors to the white matter of temporal lobe in soft type was higher than other types（P=0.005, 0.000, respectively）. Resection degree of soft tumors was higher than hard tumors（χ~2=14.13, P=0.003）. Conclusion： The ratios of T2-weighted signal intensity of pituitary macroadenomas to the white matter can be used as an indicator to preoperatively assess the consistency of pituitary tumors, which can help to find the appropriate surgical approach.