摘要
目的:利用MRI研究Rathke囊肿与垂体的位置关系及其鉴别诊断价值。方法:将48例经手术病理证实的Rathke囊肿设为囊肿组,将误诊为Rathke囊肿的垂体腺瘤18例设为对照组,利用MRI观察2组病灶在冠状位及矢状位上与垂体的位置关系,并作统计学分析。结果:①冠状位囊肿组居于垂体中份者出现率大于对照组,其差异有统计学意义(校正χ2=37.898,P=0.000)。②矢状位上囊肿组与垂体前后叶间的位置关系有3种,以位于垂体前后叶间(38例,79.2%)最多见,对照组中除4例腺瘤难以分辨与垂体前后叶的位置关系外,其余14例均位于前叶。③矢状位上囊肿组病灶出现层面与垂体柄均有交叉,其上缘多位于垂体柄垂体插入部之后(32例,66.7%);对照组中腺瘤出现层面与垂体柄交叉或不交叉,发生交叉者(12例,66.7%),其上缘位于垂体柄垂体插入部之后少见(1例,8.3%),2组柄后出现率差异有统计学意义(校正χ2=10.947;P=0.001)。结论:Rathke囊肿与垂体的位置关系有一定规律可循,且与垂体腺瘤存在着较大差异,当囊肿冠状位居于垂体中份,矢状位居于垂体前后叶间,其上缘位于垂体柄垂体插入部之后时具有较高的诊断价值。
Objective：To analyze the relationship between position of Rathke’s cleft cyst and pituitary gland by MRI and to explore its differential diagnostic value. Methods：Totally 48 cases of Rathke’s cleft cyst proved by the operation and pathology were served as cyst group,while 18 cases of pituitary adenoma which were misdiagnosed as Rathke’s cleft cyst were served as control group. The relationship between position of Rathke’s cleft cyst and pituitary gland in the coronal and sagittal plane was analyzed with MRI and was detected for statistical analysis. Results：（1）In the coronal plane,lesions locating in the middle of pituitary occurred more often in cyst group than in control group with statistical differences（corrected χ2=37.898,P=0.000）.（2）In the sagittal plane,there were three kinds of position relationship between the cyst and the anterior and posterior lobe of the pituitary gland in cyst group. The kind that the cysts were located between the anterior and posterior lobe of the pituitary gland was the most common（38 cases,79.2%）. While in control group,14 cases of pituitary adenoma were located in the anterior lobe,except for 4 cases whose position relationship with the anterior and posterior lobe of the pituitary gland was indistinguishable.（3）In the sagittal plane,all lesions and pituitary stalk appeared at the same level in cyst group. The upper edge of the cysts was usually located behind the connection of pituitary stalk and pituitary（32 cases,66.7%）. While in control group,the pituitary adenoma and pituitary stalk appeared at the same or different levels and 12 cases（66.7%）appeared at the same level of pituitary stalk. It is rare that the upper edge of the pituitary adenoma was located behind the connection of pituitary stalk and pituitary（1 case,8.3%）. Statistical analysis showed significant differences in the occurrence rate of the lesions whose upper edge was located behind the connection of pituitary stalk and pituitary（corrected χ2 test,χ2=10.947,P= 0.001）. Conclusions：Relationship between position of Rathke’s cleft cyst and pituitary gland has some rules to follow and there is a big difference between with Rathke’s cleft cyst and pituitary adenoma. It has higher value in diagnosing Rathke’s cleft cyst when the cyst is located in the middle of pituitary in the coronal plane and seated between the anterior and posterior lobe of the pituitary gland with its upper edge situated behind the connection of pituitary stalk and pituitary in the sagittal plane.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2014年第5期724-727,共4页
Journal of Chongqing Medical University
关键词
RATHKE囊肿
垂体
核磁共振
Rathke’s cleft cyst
pituitary gland
magnetic resonance imaging
