一例CT难识别的颅内咽管瘤病例报告(英)  

A Case of Intracranial Craniopharyngiomas which is Difficult to Detect with CT

作　　者：李安敏[1] 任自强[2] 何强[2] 

机构地区：[1]贵州省人民医院放射科,贵阳550002 [2]贵州省人民医院神经外科,贵阳550002

出　　处：《CT理论与应用研究（中英文）》1999年第3期49-50,共2页Computerized Tomography Theory and Applications

摘　　要：本文报导了一例CT难于诊断的颅咽管瘤。患者：男性，47岁，因间歇性头痛一年多，双眼视力减退年以上，于1992－06月入院诊治。一年前患者出现前额部隐痛，进行性加剧，半年后出现双眼视力减退的症状。曾作两次CT扫描，均未发现异常，诊断为球后视神经炎，予激素治疗40天后，双眼视力复原，头痛缓解，以后症状反复发作三次，均用激素治疗缓解。1992年再次头颅CT冠状扫描诊为鞍区病变，检查：视力右1．0，左0．4，双颞侧偏盲，眼底无水肿，眼球运动不受限，神经系统检查无特殊发现。手术发现双侧视N受压，其中间有兰色肿物予以切除，病理报告为颅咽管瘤。术后视力恢复，一月后视力再次下降，双颞侧偏盲。CT扫描未发现肿瘤复发，再次手术发现视交叉前间隙有兰色肿物，周围严重粘连，肿瘤部分囊变，有钙化，分块切除肿瘤，松解视N粘连。术后14天复查视力布0．9，左0．8．21天后双眼视力开始下降，视力维持右0．4，左0．2，复查CT无肿瘤复发。视力迅速恶化的原因可能和视N再发生粘连。影响视N血供有关。One case of a intracranial craniopharyngiomas which is difficult to detect with CT is reported in this paper. The patient to go to hospital to see a doctor one year ago, because of his headache and visual disturbance. CT examination showed that his sella area is normal and he was diagnosed as retrobulbar neuritis. His vision reconverted after operation. but it descended to preoperative level after one month. then the second operation was done ailer five months. Bilateral optic nerve wide adhesion was found through the second operation and his vision was gradually recovered after this operation, but his vision deteriorated quickly once again after several days. However. CT reexaminination showed that recurring tumor was absent.

关 键 词：颅咽管瘤 视神经 手术 CT 病例 

分 类 号：R739.41[医药卫生—肿瘤] R730.44[医药卫生—临床医学]