鞍区良性占位病变MR视束水肿样变的研究  

MR imaging study of edema-like change along optic tract in benign sellar mass lesions.

作　　者：张喜安[1] 漆松涛[1] 方陆雄[1] 潘军[1] 樊俊[1] 

机构地区：[1]南方医科大学南方医院神经外科,广州510515

出　　处：《中国神经精神疾病杂志》2009年第2期93-96,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：广东省医学科学技术研究基金(编号:A2007391)

摘　　要：目的研究视束水肿样变(OTE征)在鞍区良性占位病变的诊断学和治疗学意义。方法207例初次确诊和手术病理证实的鞍区良性占位病变患者,肿瘤均接触或压迫视交叉和/或视束,其中垂体腺瘤116例、颅咽管瘤52例、鞍区脑膜瘤18例、囊肿性病变14例、垂体脓肿7例,回顾性分析MR上OTE征的影像学特点、阳性率、与肿瘤大小和术前视觉功能障碍的关系。结果OTE征在垂体腺瘤、颅咽管瘤、鞍区脑膜瘤、囊肿性病变、垂体脓肿的阳性分别为6、20、1、0和3例。在垂体瘤,OTE征与肿瘤大小有关,而与术前视觉功能障碍无关。在颅咽管瘤,OTE征与肿瘤大小和术前视觉功能障碍均无关,与肿瘤的生长方式有关,鞍上生长的肿瘤发生OTE征的比例显著高于鞍内鞍上生长的肿瘤(P=0.003)。70.8%的OTE征在术后1个月内即可消失。结论OTE征不是颅咽管瘤的特征性表现,在手术满意切除鞍区良性占位病变后,视束水肿样变多可很快消失。Objective To study the diagnostic and therapeutic significance of edema-like change along optic tract （ OTE sign） in benign mass lesions of sellar region. Methods Two hundred and seven patients with newly diagnosed and treated benign sellar region mass lesions that were touching or compressing the optic chiasma and/or optic tract were Included. The mass lesions included 116 cases of pituitary adenoma 52 cases of craniopharyngioma, 18 cases of meningioma, 14 cases of cystic lession and 7 cases of pituitary abscess. The MR features, positive ratio, relationship of OTE sign to tumor size or pre-operative visual signs were retrospectively analyzed. Results The positive ratio of OTE sign in pituitary adenoma, craniopharyngioma, meningioma, cystic lesion and pituitary abscess was 5.2% , 38.5% , 5.6% , 0 and 42. 9% , re- spectively. In pituitary adenoma, the OTE sign was associated with tumor size, but not with the presence or absence of visu- al signs. In craniopharyngioma, the OTE sign was associated with tumor size as well as the presence or absence of visual signs. Further analysis revealed that the positive ratio of OTE sign was significantly higher in the suprasellar craniopharyngioma than in the intra- and suprasellar craniopharyngioma （P = 0. 003 ） The OTE sign disappeared in 70. 8% patients within one month postoperatively. Conclusions OTE sign is not an unique radiological feature of craniopharyngioma. After successful removal of the benign mass lesion in sellar region, the OTE sign in the majority of the patients can disappear rapidly.

关 键 词：颅咽管瘤 垂体腺瘤 脑膜瘤 囊肿 垂体脓肿 鞍区 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]