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医学免费论文:MRI在鞍区肿瘤诊断与鉴别诊断中的应用价值
【摘要】 目的 分析鞍区肿瘤的MRI影像特征，评价MRI对鞍区肿瘤的诊断价值。方法 回顾性分析80例经手术病理证实的鞍区肿瘤的MRI表现，其中垂体瘤38例，颅咽管瘤15例，脑膜瘤9例，脊索瘤5例，三叉神经瘤4例，生殖细胞瘤4例，胶质瘤3例，畸胎瘤2例，全部病例均行MRI平扫及增强检查。结果 鞍区不同类型的肿瘤有其不同的好发部位、好发年龄以及临床症状，MRI图像上也有各自的形态特征及信号特点。结论 MRI的多参数、多方位成像能够显示鞍区各种肿瘤的影像学特征，对鞍区肿瘤的诊断与鉴别诊断具有重要临床价值。
【关键词】 鞍区肿瘤;磁共振成像;鉴别诊断
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医.学全.在.线网站www.med126.com.
Key words:sellar region tumor; magnetic resonance imaging; differential diagnosis
鞍区是颅内肿瘤的好发部位之一。MRI具有无创伤、良好的组织对比度、无骨伪影干扰、多层面成像等优点，是诊断鞍区肿瘤最理想的影像学方法[12]。通过分析80例经手术病理证实的鞍区肿瘤的MRI表现，并结合文献复习，以提高对鞍区肿瘤的诊断及鉴别诊断能力。
1 材料与方法
1.1 临床资料
收集我院经手术与病理证实的鞍区肿瘤80例。其中男性34例，女性46例。年龄6～72岁，平均年龄(42.2±16.8)岁。垂体瘤38例，颅咽管瘤15例，脑膜瘤9例，脊索瘤5例，三叉神经瘤4例，生殖细胞瘤4例，胶质瘤3例，畸胎瘤2例。患者主要临床表现为：内分泌异常(肢端肥大症、闭经、泌乳素增高等)、垂体功能低下表现(性功能减退、第二性征发育差等)、视交叉受压症状(视力下降、视觉障碍等)和颅内高压症状(头痛、恶心、呕吐等)。
1.2 检查方法
全部病例均行MRI平扫及增强扫描。采用GE公司Signa 3.0T超导磁共振扫描仪，使用头颅线圈，行常规冠状位、矢状位扫描。扫描参数：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)，层厚3 mm，层间距0.5 mm，矩阵：320×192，FOV：18 cm×18 cm。所有患者均经静脉注射GdDTPA后行冠状位、矢状位及轴位增强扫描，注射剂量0.1 mmol/kg。
