MRI诊断颅咽管瘤的影像学特征研究

Study on Imaging Characteristics of MRI in Diagnosis of Craniopharyngioma

目的:分析MRI诊断下颅咽管瘤的影像学特征。方法:选择2017年2月-2020年1月本院收治的45例颅咽管瘤患者,均给予CT以及MRI检查,以手术病理诊断为金标准,比较CT、MRI检出率、灵敏度、特异度、阳性预测值、阴性预测值。结果:MRI灵敏度为97.78%高于CT的80.00%,差异有统计学意义(P<0.05);MRI与CT阳性预测值均为100%,特异度以及阴性预测值均为0,差异均无统计学意义(P>0.05)。MRI检出15例鞍上向脑干、鞍旁包绕血管,占34.09%;12例鞍上向鞍内生长,占27.27%;13例鞍上及三脑室,占29.55%;4例鞍上池,占9.09%。CT检出12例鞍上向脑干、鞍旁包绕血管,占33.33%;10例鞍上向鞍内生长,占27.78%;11例鞍上及三脑室,占30.56%;3例鞍上池,占8.33%。结论:颅咽管瘤影像学特征呈多种形态,MRI可显著提高颅咽管瘤检出率,且具有较高的灵敏度,为疾病的诊断、鉴别提供重要的参考依据,值得借鉴。

Objective:To analyze the imaging characteristics of craniopharyngioma under MRI diagnosis.Method:From February 2017 to January 2020,45 patients with craniopharyngioma in our hospital were examined by CT and MRI respectively.With surgical pathology as the gold standard,CT,MRI detection rate,sensitivity,specificity,positive predictive value and negative predictive value were compared.Result:The sensitivity of MRI was 97.78%higher than 80.00%of CT,the difference was statistically significant(P<0.05).The positive predictive value of MRI and CT were 100%,the specificity and negative predictive value were 0,the differences were not statistically significant(P>0.05).MRI detected 15 cases of supra sella brain stem and perisella surrounding blood vessels,accounting for 34.09%.12 cases of upside-down saddle growth,accounted for 27.27%.13 cases of suprasellar and third ventricle,accounting for 29.55%.4 cases of suprasellar cistern,accounting for 9.09%.CT detected 12 cases of suprasellar to brainstem and parasellar vessels,accounting for 33.33%.10 cases of suprasellar to intrasellar growth,accounting for 27.78%.11 cases of suprasellar and third ventricle,accounting for 30.56%.3 cases of suprasellar cistern,accounting for 8.33%.Conclusion:The imaging features of craniopharyngioma are various.MRI can significantly improve the detection rate of craniopharyngioma,and has high sensitivity.It can provide important reference for the diagnosis and differential diagnosis of craniopharyngioma.