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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(lèi)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(xiàn)網(wǎng)站payment-defi.com.
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。患者主要臨床表現(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(xiàn)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。
