摘要
目的 探讨“高风险垂体腺瘤”的CT和MRI影像特征及诊断要点。方法 回顾性分析2017年6月至2020年9月由北京大学国际医院手术病理诊断为“高风险垂体腺瘤”的临床资料并探讨其影像表现。结果 “高风险垂体腺瘤”患者共24例,其中男性14例,女性10例,平均年龄45岁。临床表现为鞍区占位或激素分泌异常的症状。肿瘤最大径0.9-4.9cm,其中微腺瘤2例,位于鞍内,另有19例突破蝶鞍表现为束腰征,大腺瘤7例,巨大腺瘤15例。形状不规则15例,实性成分密度不均匀9例,囊变、出血、坏死11例,视交叉受压18例,三脑室受压7例,脑干受压1例,周围浸润生长21例,鞍底受累12例,海绵窦受累18例。14例获得随访资料,其中1例死亡,1例复发,其余无瘤生存。结论 本研究中“高风险垂体腺瘤”大部分为大腺瘤和巨大腺瘤,且多具有影像学侵袭性,易侵及周围骨质及海绵窦,且囊变、出血、坏死多见。术前评估肿瘤影像征象和周围结构的关系,有助于手术方式和术后治疗措施的选择。
Objective To investigate the CT and MRI features and diagnostic points of"high-risk pituitary adenoma".Methods The clinical data of"high-risk pituitary adenoma"diagnosed by surgery and pathology in Peking University International Hospital from June 2017 to September 2020 were analyzed retrospectively,and its imaging manifestations were discussed.Results There were 24 patients with"high-risk pituitary adenoma",including 14 males and 10 females,with an average age of 45 years.The clinical manifestations were space occupying in sellar region or abnormal hormone secretion.The maximum diameter of the tumor was 0.9-4.9cm,including 2 cases of microadenoma,located in the sella,19 cases of breaking through the sella,7 cases of macroadenoma and 15 cases of giant adenoma.There were 15 cases of irregular shape,9 cases of uneven density of solid components,11 cases of cystic degeneration,hemorrhage and necrosis,18 cases of optic chiasmatic compression,7 cases of third ventricle compression,1 case of brainstem compression,21 cases of peripheral infiltration and growth,12 cases of sellar floor involvement and 18 cases of cavernous sinus involvement.Follow up data were obtained in 14 cases,of which 1 case died,1 case recurred,and the rest survived without tumor.Conclusion Most of the"high-risk pituitary adenomas"in this study are macroadenomas and giant adenomas,and most of them are imaging invasive,easy to invade the surrounding bone and cavernous sinus,and cystic degeneration,bleeding and necrosis are common.Preoperative evaluation of the relationship between tumor imaging signs and surrounding structures is helpful to the selection of surgical methods and postoperative treatment measures.
作者
张恩龙
张铭
李媛
ZHANG En-long;ZHANG Ming;LI Yuan(Department of Radiology,Peking University Third Hospital,Beijing 100191,China;Department of Radiology,Peking University International Hospital,Beijing 102206,China;Department of Pathology,Peking University International Hospital,Beijing 102206,China)
出处
《中国CT和MRI杂志》
2023年第4期25-27,35,共4页
Chinese Journal of CT and MRI
基金
国家自然科学基金(81901791)
北京大学国际医院院内科研基金(YN2019QN03)。
关键词
高风险
垂体腺瘤
CT
MRI
High-Risk
Pituitary Adenoma
Computed Tomography
Magnetic Resonance Imaging
