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目的评价MRI对鞍上肿瘤的诊断价值。方法回顾性分析我院23例鞍上肿瘤患者临床及头颅MRI资料,其中颅咽管瘤8例,脑膜瘤5例,室管膜瘤和生殖细胞瘤各3例,毛细胞星形细胞瘤和表皮样囊肿各2例。结果颅咽管瘤边界光整,肿瘤以囊性或囊性成分为主;囊性部分呈短T1、长T2信号5例,长T1、长T2信号2例,等T1、长T2信号1例;增强扫描肿瘤实质部分显著强化。5例脑膜瘤4例起源于鞍结节,1例起源于前床突,肿瘤边界光整;平扫呈等T1、稍长T2信号;增强后均匀显著强化,可见“脑膜尾征”。室管膜瘤形态极不规则,2例侵犯额叶,1例侵犯丘脑;肿瘤呈长T1、长T2信号;1例见有团块状钙化(T2WI呈低信号);增强扫描显著强化。生殖细胞瘤形态较规则,肿瘤沿垂体柄向鞍内生长,致垂体柄增粗,T1WI垂体后叶高信号消失;1例表现颅内多发病灶:2例平扫呈长T1、稍长T2信号,1例呈长T1、长T2信号,瘤内有较多数量小圆形囊变区;增强扫描肿瘤强化明显。2例毛细胞星形细胞瘤呈浅分叶状,肿瘤沿视路生长,1例肿瘤跨越前、中、后颅窝,1例显示一侧视神经增粗;平扫肿瘤呈长T1、长T2信号,边缘见有多个新月状囊变区;增强扫描肿瘤显著强化。2例表皮样囊肿形态不规则,肿瘤向后蔓延生长至环池和桥前池;呈长T1、长T2信号,内见线样间隔;增强后无强化。结论不同类型鞍上肿瘤MRI表现不同,MRI对鞍上肿瘤诊断具有重要价值。
Objective To evaluate the value of MRI in the diagnosis of suprasellar tumors. Methods The clinical and cranial MRI data of 23 patients with suprasellar tumors in our hospital were retrospectively analyzed. Among them, 8 were craniopharyngioma, 5 were meningioma, 3 were ependymoma and germ cell tumor, 3 were hair cell astrocytoma, Epidermoid cysts in 2 cases. Results The craniopharyngioma border was smooth and the tumor was mainly cystic or cystic. The cystic part was short T1, long T2 signal 5 cases, long T1, long T2 signal 2 cases, T1 and T2 signal 1 case ; Enhanced scan of the substantial part of the tumor was significantly enhanced. 5 cases of meningioma originated in the saddle nodules, 1 case originated in the anterior bed bump, tumor border polished; plain scan was T1, slightly longer T2 signal; enhanced significantly enhanced after uniform, we can see . The morphology of ependymomas was very irregular, 2 cases of invasion of the frontal lobe, and 1 case of invasion of the thalamus. The tumors showed long T1 and long T2 signals. One case had massive calcification (T2WI showed low signal). The enhanced scan was significantly enhanced. Germ cell tumor morphology is more regular, the tumor along the pituitary stalk to saddle growth, causing pituitary stalk thickening, T1WI pituitary gland high signal disappears; 1 case showed multiple intracranial lesions: 2 cases were long T1, slightly longer T2 signal , A case of long T1, long T2 signal, the tumor has a larger number of small cystic lesions; enhanced scan enhancement of the tumor. 2 cases of hairy astrocytoma showed a shallow lobular tumor along the visual pathway growth, 1 case of tumor across the anterior, middle and posterior fossa, 1 case showed optic nerve thickening; plain tumor was long T1, long T2 Signals, see the edge of a number of crescent-shaped cystic area; enhanced scan significantly enhanced. 2 cases of epidermoid cyst irregular shape, the tumor spread back to the Central pool and the bridge before the pool; was long T1, long T2 signal, see line-like interval; no enhancement after enhancement. Conclusion The MRI findings of different types of suprasellar tumors are different. MRI is of great value in the diagnosis of suprasellar tumors.