垂体Rathke氏囊肿的MRI诊断

MRI Diagnosis in Patient with Pituitary Rathke's Cysts

目的 :探讨MRI诊断垂体Rathke氏囊肿的价值。材料和方法 :收集经病理证实的垂体Rathke氏囊肿的病例共18例 ,均行常规及增强MRI检查 ,其中 9例加扫反转恢复 (IR)序列。结果 :所有 18例Rathke氏囊肿MRI均显示鞍内或向鞍上发展的圆形或椭圆形肿物。 5例伴有液平面形成。病变直径小于 1cm者 4例 ;1～ 3cm者 12例 ;大于 3cm者 2例。MR呈短T1信号者 14例 ,其中长T2 9例 ,短T2 5例 ;MR呈长T1长T2信号者 4例。增强扫描 ,其中有 7例于囊肿边缘出现环形强化。囊壁病理学检查结果显示 ,17例为单层立方或柱状上皮细胞 ,其中 2例含有杯状细胞 ;1例混有假复层鳞状上皮细胞 ;1例合并有嗜酸性细胞垂体腺瘤。结论 :MRI对于本病的诊断和鉴别诊断有一定的价值。

Purpose: To evaluate the value of MRI in the diagnosis of pituitary Rathke's cyst. Materials and Methods: 18 cases of Rathke's cysts confirmed by operation and pathology were collected. Plain and contrast-enhanced MR examinations were performed in all cases. In 9/18 cases, an inversion recovery sequence was carried out in the meantime. Results: Oval or rounded tumor-like appearances in sella turcica with tendency of upward growth were present on MRI. Fluid levels were found in 5 cases. The diameters of the lesions were less than 1 cm in 4 cases, between 1 and 3 cm in 12 cases, and larger than 3 cm in 2. On MRI, short T1 were present in 14 cases, in which, 9 cases with long T2 high signal intensity, 5 cases with short T2 low intensity, and 4 cases with long T1 and T2 signal intensity. Circular enhancement at the margin of lesion was showed after contrast-enhanced MR examination in 7/18. Pathological results of cyst wall showed that single layer cubic or columnar epithelium was present in 17 cases, in which, goblet cell contained in 2, pseudo-pavement epithelium cells mixed in 1, acidophilic adenoma combined in one case. Conclusion: MRI is valuable in diagnosis and differential diagnosis of Rathke's cyst.