“液-液平面”征象在鞍区病变中的鉴别诊断价值  

The values of fluid - fluid level in the differential diagnosis of the sellar lesions

作　　者：肖德勇[1] 王守森[1] 赵琳[1] 魏梁锋[1] 荆俊杰[1] 黄银兴[1] 

机构地区：[1]南京军区福州总医院神经外科,350025

出　　处：《中华神经外科杂志》2013年第8期776-780,共5页Chinese Journal of Neurosurgery

基　　金：南京军区医学科技创新重点项目（11Z034）

摘　　要：目的阐释“液-液平面”征象在鞍区病变中的鉴别诊断价值。方法收集经手术和病理证实的鞍区占位性病变266例，进行MRI影像和临床病理分析。结果本组266例中，垂体腺瘤209例（48例伴液平面形成，其中1个液平面24例，2个液平面9例，3个及以上液平面15例）；颅咽管瘤35例；Rathke囊肿19例；垂体脓肿2例；表皮样囊肿1例。液平面发生率在囊性垂体腺瘤中为54．5％（48／88），明显比颅咽管瘤（2／35）、Rathke囊肿（1／19）等病变高（P〈0．01），颅咽管瘤与Rathke囊肿之间差异无统计学意义（P〉0．05）。结论“液-液平面”最常见于垂体腺瘤，尤其是伴多个液平面者，且以无功能型、促性腺激素型、催乳素型和多功能型垂体腺瘤多见。“液平面”常提示垂体腺瘤出血亚急性期。Objective This paper aims to interpret the special imaging appearance of ＂liquid - liquid level＂ in differential diagnosis of sellar region lesions. Methods The MR imaging appearance and histological features of 266 operated sellar lesions were scrutinized. Results Among all the 266 cases, there are 209 cases of pituitary adenomas （ including 88 cases with cystic degeneration, 48 cases with fluid - fluid level, and a single fluid level in 24 cases, two fluid levels in 9 cases, more than three levels in 15 cases） ; 35 cases of craniopharyngioma; 20 cases of Rathke cyst; 1 case of epidermoid cyst and 2 cases of abscess. The incidences of cystic formation and fluid - fluid level in pituitary adenomas were significantly （ P 〈 0. 01 ） higher than the other seflar region lesions, whereas there were non - significant difference between craniopharyngiomas and Rathke cyst lesions （ P 〉 0. 05 ）. Conclusions The signs of fluid - fluid level are most common in pituitary adenomas, especially with multiple fluid levels, and more in non - functional, FSH/LH, PRL, and multi -functional pituitary adenomas. Fluid -fluid levels often suggest the subacute hemorrhage in pituitary adenomas.

关 键 词：垂体腺瘤 磁共振成像 鉴别诊断 液-液平面 

分 类 号：R445.2[医药卫生—影像医学与核医学]