垂体Rathke囊肿蛋白小体的影像学特征分析

Imaging features of intracystic nodules in Rathke cleft cysts: a preliminary study in a single center

目的探讨垂体Rathke囊肿蛋白小体的影像学特征,提高对Rathke囊肿蛋白小体的认识。方法回顾性分析2016年1月至2019年1月手术治疗的、术后病理检查确诊的12例含有蛋白小体的垂体Rathke囊肿的影像学资料,分析其术前影像学特点。结果75%的含有蛋白小体的Rathke囊肿CT呈高密度,平均CT值(58.45±11.62)Hu;蛋白小体最大直径平均(4.53±1.62)mm。蛋白小体MRI平扫T_(1)相中呈稍高信号或高信号,T_(2)相呈明显低信号,增强扫描无明显强化。依据形态,蛋白小体可分球体型、块状型和干涸型。蛋白小体在Rathke囊肿内的位置可以分为悬浮型和贴壁型。结论蛋白小体为Rathke囊肿内一种特有的内容物,CT和MRI具有多元的影像学特征,认识这些特征对Rathke囊肿的精准诊断和鉴别诊断有重要意义。

Objective To discuss the imaging features of intracystic nodules in Rathke cleft cysts.Methods The imaging data of 12 patients with Rathke cleft cyst containing intracystic nodules who were surgically treated and confirmed by postoperative pathological examination from January 2016 to January 2019 were retrospectively analyzed,and the preoperative imaging characteristics were analyzed.Results Rathke cysts containing intracystic nodules in 9 of 12 patients(75%)showed high density on CT,with an average CT value of(58.45±11.62)Hu.The average maximum diameter of intracystic nodules was(4.53±1.62)mm.Intracystic nodules appeared slightly hyperintense or hyperintense in MR unenhanced T_(1) phase and markedly hypointense in T_(2) phase,with no obvious enhancement of intracystic nodules in the enhanced scans.Intracystic nodules were classifiable as globular,block and solid forms according to morphology.The location of intracystic nodules within Rathke's cyst can be divided into two types,i.e.,suspension and adherent.Conclusions Intracystic nodules,which have multiple imaging features on CT and MRI,is a unique content within Rathke cysts.Understanding these features is of great significance for accurate diagnosis and differential diagnosis of Rathke cysts.