全瘤型垂体卒中MRI特征及相关因素分析

MRI features and related factors of complete pituitary apoplexy

目的探讨全瘤型垂体卒中(PA)的MRI特征及相关因素。方法回顾性分析24例经病理确诊的全瘤型PA病人的临床资料,评估术前病变MRI信号、液液平面、囊肿分隔、蝶窦分型,结合术中所见和组织病理进行分析。结果 24例全瘤型PA病变平均大小(25.41±7.13)mm;蝶窦分型呈全鞍型20例,半鞍型3例,鞍前型1例;MRI上伴液平者16例,无液平者8例;不同性别组在肿瘤大小、囊肿分隔、免疫组化分型间差异具有统计学意义(P<0.05)。结论全瘤型PA临床少见,女性相对多发;MRI上伴有液液平面、全鞍型蝶窦以及囊肿分隔表现,有助于临床诊断与鉴别。

Objective To investigate the MRI features and related factors of complete pituitary apoplexy（PA）. Methods Clinical data of 24 patients with complete PA confirmed by pathology were analyzed retrospectively. The preoperative MRI tumor signal, fluid-fluid level, cyst separation and sphenoid sinus type were evaluated in combination with intraoperative findings and histopathology. Results The mean lesion size of 24 patients with complete PA was 25.41 ± 7.13 mm. Full-saddle sphenoid sinus type was showed in 20 patients, middle-saddle in 3, presaddle in 1. MRI showed 16 patients with fluid level and 8 without fluid level. There were significant differences in tumor size, cyst separation, and immunohistochemistry between different gender groups（ P〈0.05）. Conclusions Complete PA is rare in clinic, and it is relatively frequent in females. On the MRI, there are fluid-fluid level, full-saddle sphenoid sinus,and cyst separation, which are helpful for clinical diagnosis and differentiatial diagnosis.