以视觉障碍为首发症状的鞍区占位性病变的影像学研究

Imaging Study of Sellar Occupying Lesions with Visual Disturbance as the First Symptom

目的探讨视觉障碍为首发症状的鞍区占位性病变影像学表现,提高鞍区占位性病变影像学的认识。方法回顾性分析2018年6月至2021年11月我院诊治的30例经手术病理诊断的以视觉障碍为首发症状的鞍区占位性病变CT、MRI影像特点及临床资料。结果垂体大腺瘤12例,颅咽管瘤6例,Rathke囊肿4例,鞍区脑膜瘤2例,胶质瘤3例,表皮样囊肿2例,生殖细胞瘤1例。所有病例经手术病理证实,CT与手术、病理符合率83.3%,MRI与手术、病理符合率93.3%。结论以视觉障碍为首发症状的鞍区占位性病变种类繁多,但依据病灶发生的部位及影像特点,CT和MRI相结合,多能术前作出较明确诊断。

Objective To investigate the imaging findings of sellar space-occupying lesions with visual impairment as the first symptom,and to improve the imaging understanding of sellar space-occupying lesions.Methods CT and MRI imaging features and clinical data of 30 cases of sellar occupying lesions with visual impairment as the first symptom diagnosed by surgery and pathology in our hospital from June 2018 to November 2021 were retrospectively analyzed.Results There were 12 cases of large pituitary adenoma,6 cases of craniopharyngioma,4 cases of Rathke cyst,2 cases of sellar meningioma,3 cases of glioma,2 cases of epidermoid cyst and 1 case of germinoma.The coincidence rate of CT examination and MRI examination was 83.3% and 93.3% respectively.Conclusions There are many types of space occupying lesions in the sellar region with visual disturbance as the first symptom,but according to the location and image characteristics of the lesions,CT and MRI can be combined to make more definite diagnosis before surgery.