原发性甲状腺功能减退导致垂体增生的MRI表现  

MRI of Pituitary Hyperplasia due to Primary Hypothyroidism

作　　者：唐颖[1] 张俊海[1] 李益明[2] 梁宗辉[3] 

机构地区：[1]复旦大学附属华山医院放射科 [2]复旦大学附属华山医院内分泌科 [3]复旦大学附属静安区中心医院放射科

出　　处：《中国医学计算机成像杂志》2014年第1期1-4,共4页Chinese Computed Medical Imaging

摘　　要：目的:分析原发性甲状腺功能减退患者垂体增生的MRI表现。方法:收集30例临床诊断甲状腺功能减退、MRI显示垂体病变的患者,回顾性研究其MRI表现;经甲状腺素替代治疗后随访垂体MRI,对比治疗前后垂体病变的变化。结果:本组患者多为儿童及青年女性,其中71.88%的患者年龄在30岁以下,男女比例为1:6.5。垂体MRI显示垂体存在不同程度的增大,垂体高度最大可达18mm,但垂体信号均匀,增强后均匀强化,除1例外垂体柄均居中。其中3例行手术治疗,术后病理提示垂体增生。其他患者经甲状腺素替代治疗后随访,增大的垂体恢复到正常范围内,治疗前后垂体高度的差异具有统计学意义(P<0.001)。结论:原发性甲状腺功能减退导致的垂体增生具有特征性的MRI表现;经甲状腺素替代治疗后复查垂体MRI显示增大的垂体,恢复到正常范围内;MRI检查是诊断原发性甲状腺功能减退导致垂体增生的有效手段,术前正确诊断可避免不必要的手术。Purpose： To analyze the MRI features of pituitary hyperplasia due to primary hypothyroidism. Methods： MRI scans were performed in 30 patients who were confirmed to have primary hypothyroidism by the clinical diagnosis. MRI features of them with pituitary disorders were analyzed. After thyroid hormone replacement therapy, follow-up MRI was performed. MRI features of the pituitary were compared before and after therapy, Results： Of all the patients, 71.88% were child and young females who were below 30 years old. The ratio of males to females was 1：5.5. The pituitary MRI showed that all the patients＇ pituitary glands were enlarged in different degrees, the highest was about 18mm. The signals of the masses were all homogeneous before and after contrast. The stalks were not shifted except only one patient. Three patients were operated as adenoma and confirmed by pathology. After thyroid hormone replacement therapy, the follow-up MRI demonstrated that the enlarged glands mostly became normal. The heights of the pituitary glands were revealed a significant difference between that got before therapy and after therapy （P〈0.001）. Conclusion： Hyperplasia of the pituitary gland due to primary hypothyroidism has typical MRI features. After thyroid hormone replacement therapy, the follow-up MRI demonstrated that the enlarged glands became normal. MRI is the first choice to demonstrate pituitary hyperplasia in primary hypothyroidism. Radiologists should be aware of this entity, since the condition responds to medical treatment and the patients may be spared from unnecessary surgery.

关 键 词：垂体增生 磁共振成像 原发性甲状腺功能减退 

分 类 号：R445.2[医药卫生—影像医学与核医学]