摘要
目的：分析垂体卒中的ＣＴ，ＭＲＩ表现与临床表现，探讨ＣＴ，ＭＲＩ对垂体卒中的诊断价值。材料和方法：对手术和病理证实的４６例垂体卒中进行回顾性分析。男性２０例，女性２６例，年龄２３～６９岁，平均４４岁。４６例中，３２例行ＣＴ检查，其中单纯平扫７例，平扫＋增强２５例；４６例均作ＭＲＩ检查，其中单纯平扫１４例，平扫＋增强３２例。结果：４６例均为垂体大腺瘤基础上并发出血和（或）坏死。３２例ＣＴ检查中，垂体瘤出血１７例，表现为片状高密度影；肿瘤内坏死７例，表现为不规则低密度区；出血合并坏死８例，表现为高密度与低密度并存；２５例增强后扫描显示出血、坏死区均无强化，肿瘤实质区可见强化。 ４６例ＭＲＩ检查中，瘤内出血２９例，表现为Ｔ_１ＷＩ，Ｔ_２ＷＩ均呈高信号；肿瘤内坏死１０例，表现为Ｔ_１ＷＩ低信号，Ｔ_２ＷＩ高信号；出血合并坏死８例，Ｔ_１ＷＩ表现为高低混合信号，Ｔ_２ＷＩ表现为高信号；３２例增强扫描显示出血和坏死区均无强化，肿瘤实质区可见强化。临床症状均为突发性包括头痛２６例，视觉障碍２２例，动眼神经麻痹１３例，恶心、呕吐８例，精神改变７例，脑膜刺激征６例，偏瘫４例，发热２例。结论：ＣＴ。
Purpose: To investigate the value of CT and MRI in the diagnosis of pituitary apoplexy by analyzing the CT, MRI and clinical appearances. Materials and Methods: Forty six cases of pituitary apoplexy , proven surgically and pathologically , were analyzed retrospectively. The age of 20 men and 26 women ranged from 23 to 69 years(mean 44 years). 32 patients underwent CT examinations with (n = 25) and without(n = 32) intravenous injection contrast media. MRI were carried out for 46 cases and 32 of them had Gd - enhanced T1 WI studies. Results: All the 46 cases of pituitary apoplexy suffered from a sudden hemorrhage or infarction of pituitary macroadenomas. Among 32 plain CT scans, 17 cases showed patchy high density shadows compat- ible with hemorrhage of pituitary rnacroadenomas. 7 cases showed irregular hypodensity area within the tumors mass compatible with necrosis, and 8 showed iso - , hyper - and hypo - mixed density in the tumor compatible with hemorrhage accompanying with necrosis. No enhancement could be revealed in the areas of hemorrhage and necrosis on the postcontrast CT images. MRI findings of 46 cases included: 29 cases of hemorrhage in tumors with high intensity on both T1 WI and T2 WI; 10 cases of necrosis with low intensity on T1 WI and high intensity on T2 WI; 8 cases of hemorrhage and necrosis. No enhancement could be seen in the areas of hemorrhage and necrosis on the post - contrast MR images. The clinical presentations were abrupt onset of one or more of the following symptoms, including severe headache(n = 26); visual disturbance (n = 22); oculomotor nerve parests(n = 13); nausea and vomitting(n = 8); altered mental status(n = 7); meningeal irritation(n = 6); hemiplegia(n = 4) and fever(n = 2). Conclusion: CT and MRI combined with clinical presentations are of great value in the diagnosis , treatment and follow up of pituitary apoplexy.
出处
《中国医学计算机成像杂志》
CSCD
2000年第3期145-148,共4页
Chinese Computed Medical Imaging
