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醫(yī)學(xué)免費(fèi)論文:MRI在鞍區(qū)腫瘤診斷與鑒別診斷中的應(yīng)用價(jià)值
【摘要】 目的 分析鞍區(qū)腫瘤的MRI影像特征，評(píng)價(jià)MRI對(duì)鞍區(qū)腫瘤的診斷價(jià)值。方法 回顧性分析80例經(jīng)手術(shù)病理證實(shí)的鞍區(qū)腫瘤的MRI表現(xiàn)，其中垂體瘤38例，顱咽管瘤15例，腦膜瘤9例，脊索瘤5例，三叉神經(jīng)瘤4例，生殖細(xì)胞瘤4例，膠質(zhì)瘤3例，畸胎瘤2例，全部病例均行MRI平掃及增強(qiáng)檢查。結(jié)果 鞍區(qū)不同類型的腫瘤有其不同的好發(fā)部位、好發(fā)年齡以及臨床癥狀，MRI圖像上也有各自的形態(tài)特征及信號(hào)特點(diǎn)。結(jié)論 MRI的多參數(shù)、多方位成像能夠顯示鞍區(qū)各種腫瘤的影像學(xué)特征，對(duì)鞍區(qū)腫瘤的診斷與鑒別診斷具有重要臨床價(jià)值。
【關(guān)鍵詞】 鞍區(qū)腫瘤;磁共振成像;鑒別診斷
The application value of MRI in the diagnosis and differential diagnosis of sellar region tumorsYANG Jinyong1，2, ZHAO Bin2, YU Taifei2, MA Yanhong3, CAO Jinfeng2(1.Taishan Medical College, Taian 271016,China;2.Shandong Medical Imaging Research Institute，Jinan 250021,China;3.Weifang Medical College,Weifang 261042, China)Abstract:Objective:To analyze the MRI features of sellar region tumors and to evaluate the MRI diagnosis value. Methods: The MRI findings of 80 cases with sellar region tumors proved by operation and pathology were analyzed retrospectively.There were 38 cases of pituitary adenoma,15 cases of craniopharyngioma, 9 cases of meningioma,5 cases of chordoma,4 cases of trigeminal neuroma,4 cases of germinoma,3 cases of glioma, 2 cases of teratoma,and all of the cases were performed conventional and enhanced MRI. Results:Different types of the sellar region tumors had their specific predilection sites, predilection ages and clinical symptoms,and the MRI images had their respective morphologic and signal characteristics. Conclusion: Multiparameter and multidirection images can show the different imaging features of various sellar region tumors,and MRI is of great value in diagnosis and differential diagnosis of sellar region tumors醫(yī).學(xué)全.在.線網(wǎng)站gydjdsj.org.cn.
Key words:sellar region tumor; magnetic resonance imaging; differential diagnosis
鞍區(qū)是顱內(nèi)腫瘤的好發(fā)部位之一。MRI具有無(wú)創(chuàng)傷、良好的組織對(duì)比度、無(wú)骨偽影干擾、多層面成像等優(yōu)點(diǎn)，是診斷鞍區(qū)腫瘤最理想的影像學(xué)方法[12]。通過(guò)分析80例經(jīng)手術(shù)病理證實(shí)的鞍區(qū)腫瘤的MRI表現(xiàn)，并結(jié)合文獻(xiàn)復(fù)習(xí)，以提高對(duì)鞍區(qū)腫瘤的診斷及鑒別診斷能力。
1 材料與方法
1.1 臨床資料
收集我院經(jīng)手術(shù)與病理證實(shí)的鞍區(qū)腫瘤80例。其中男性34例，女性46例。年齡6～72歲，平均年齡(42.2±16.8)歲。垂體瘤38例，顱咽管瘤15例，腦膜瘤9例，脊索瘤5例，三叉神經(jīng)瘤4例，生殖細(xì)胞瘤4例，膠質(zhì)瘤3例，畸胎瘤2例�；颊咧饕R床表現(xiàn)為：內(nèi)分泌異常(肢端肥大癥、閉經(jīng)、泌乳素增高等)、垂體功能低下表現(xiàn)(性功能減退、第二性征發(fā)育差等)、視交叉受壓癥狀(視力下降、視覺(jué)障礙等)和顱內(nèi)高壓癥狀(頭痛、惡心、嘔吐等)。
1.2 檢查方法
全部病例均行MRI平掃及增強(qiáng)掃描。采用GE公司Signa 3.0T超導(dǎo)磁共振掃描儀，使用頭顱線圈，行常規(guī)冠狀位、矢狀位掃描。掃描參數(shù)：T1WI采用FSE序列(COR：TR = 580 ms、TE=9.4 ms;SAG：TR=580 ms、TE=14.0 ms);T2WI采用FSE序列(COR：TR=3200 ms、TE=118.5 ms)，層厚3 mm，層間距0.5 mm，矩陣：320×192，F(xiàn)OV：18 cm×18 cm。所有患者均經(jīng)靜脈注射GdDTPA后行冠狀位、矢狀位及軸位增強(qiáng)掃描，注射劑量0.1 mmol/kg。
