囊内结节的MRI特征对Rathke's囊肿的诊断价值  

Value of intracystic nodules on MRI to diagnosis of Rathke's cleft cyst

作　　者：齐春晓[1] 王宁[1] 

机构地区：[1]哈尔滨医科大学附属第一医院神经外科,哈尔滨150001

出　　处：《中国临床神经外科杂志》2014年第4期212-214,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨Rathke's囊肿囊内结节的MRI特点反其对Rathke's囊肿术前诊断的作用。方法回顾性分析22例经术后病理学证实的Rathke's囊肿患者的影像学资料,评价囊内结节MRI特点的诊断价值。结果 22例患者中14例病变位于鞍内,6例向鞍上发展,2例位于垂体上方;T1高信号12例,等或低信号6例,信号不均4例;T2高信号7例,等或低信号10例,信号不均5例。5例可见囊内结节,表现为T1高信号3例,等信号1例,未显示1例;T2均呈低信号,均无强化效应。5例伴囊内结节性患者术前正确诊断率100%,其余17例术前正确诊断率为64.7%(11/17)。结论 Rathke's囊肿的术前诊断较为困难,MRI显示囊内有结节的比例尽管不高,但具有特异性诊断价值。Objectives To investigate the imaging characteristics of intracystic nodules in Rathkes cleft cysts （RCC） and analyze the important role of intracystic nodules in making preoperative diagnosis of RCC. Methods The imaging data of 22 patients with RCC confirmed by surgery were retrospectively analyzed and the value of the intracystic nodules on preoperative cranial MRI to the diagnosis of RCC was analyzed. Results The correct diagnosis of RCC was preoperatively made in 16 cases. The intracystic nodules were found in 5 patients with RCC which were definitely diagnosed as RCC before the operation. The intracystic nodules presented high signal on T weighted image （T1WI） in 3 cases, iso＇signal on TWI in 1 case, and no definite signal on %WI in 1 case, but they presented low signal on T2 weighted image and had no enhancement after the administration of gadopentetate dimeglumine in these 5 cases. The rate of preoperative correct diagnosis was 64.7% in other 17 cases without intracystic nodules. RCC were only in intrasellar region in 14 patients, had suprasellar extension besides intrasellar lesions in 6 and were above the pituitary gland in 2. Conclusions The preoperative diagnosis of RCC is difficult. The rate of intracystic nodule in RCC is relatively lower on MRI, but it has specific value to making definite diagnosis of RCC.

关 键 词：Rathke’s囊肿 囊内结节 磁共振成像 诊断 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]