CT、MRI诊断鞍区囊性病变

摘要

Objective To analyze CT and MRI characteristics of sellar cystic lesions.Methods Clinical and imaging data of 83 sellar cystic lesions were retrospectively analyzed.The location,size,number of the sac,thickness of the wall and some special signs,such as mural nodules,cavernous sinus invasion were observed.Results Totally 83 patients with sellar cystic lesions including cystic pituitary adenoma (n=33),craniopharyngioma (n=28),rathke cleft cyst (n-15),dermoid cyst (n =2),epidermoid cyst (n =2),arachnoid cyst (n =2) and pituitary abscess (n =1) were enrolled.The cystic pituitary adenoma and arachnoid cyst showed low signal on T1WI and high signal on T2WI.The signal of Rathke cleft cyst and craniopharyngioma displayed complex.Dermoid cysts,epidermoid cyst and pituitary abscess exhibited high signal on DWI.There were significant statistic differences of the size,number of the sac and the wall thickness among cystic pituitary adenomas,craniopharyngiomas and Rathke cleft cysts (all P＜0.05).Conclusion Observation of imaging features,including location,shape,signal intensity,characteristics of the capsule and some special signs can improve differential diagnosis of cystic lesion of sellar region.%目的 分析鞍区囊性病变的CT、MRI影像特征.方法 回顾性分析83例鞍区囊性病变患者的临床和影像学资料,观察囊性病灶的位置、大小、囊的数目、囊壁厚度及壁结节、海绵窦包绕等特殊征象.结果 83例中,囊性垂体瘤33例、囊性颅咽管瘤28例、Rathke囊肿15例、皮样囊肿2例、表皮样囊肿2例、蛛网膜囊肿2例、垂体脓肿1例.囊性垂体瘤、蛛网膜囊肿主要表现为T1WI低信号,T2WI高信号;囊性颅咽管瘤及Rathke囊肿信号表现复杂;皮样囊肿、表皮样囊肿及垂体脓肿DWI呈高信号.3种常见鞍区囊性病变(囊性垂体瘤、囊性颅咽管瘤、Rathke囊肿)间囊的大小、数量及囊壁厚度差异均有统计学意义(P均＜0.05).结论 根据囊性病变的位置、形态、信号特征、囊的特点及一些特殊征象,可提高对鞍区囊性病变的鉴别诊断能力.