MRI对垂体柄阻断综合征的诊断价值  

Diagnostic value of MRI in pituitary stalk interruption syndrome

作　　者：迟婧[1] 宋琦[1] 岳婧婧[1] 丁蓓[1] 黄娟[1] 凌华威[1] 方文强[1] 陈克敏[1] 严福华[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,上海200025

出　　处：《诊断学理论与实践》2014年第5期487-490,共4页Journal of Diagnostics Concepts & Practice

基　　金：国家临床重点专科建设项目;上海高校一流学科(B类)建设项目

摘　　要：目的 ：探讨垂体柄阻断综合征（pituitary stalk interruption syndrome,PSIS）的MRI特点及其临床意义。方法：40例PSIS患者行MRI扫描及激素水平检测。所有患者均行液体衰减反转恢复（fluid attenuated inversion recovery,FLAIR）序列T1WI及快速SE序列T2WI、FLAIR T1WI脂肪抑制序列及增强序列（冠状位T1WI动态增强及延迟期轴位、冠状位及矢状位T1WI）扫描,分析垂体柄、垂体前叶形态和垂体后叶信号变化。结果：40例患者的基础生长激素（growth hormone,GH）水平为0.01~1.44μg/L,GH激发试验峰值为0.024~1.750μg/L,均为完全GH缺乏。其中,38例为多垂体激素缺乏,2例为单一性GH缺乏。患者垂体前叶高度为1.2~3.5 mm,平均为（2.6±1.3）mm,均有不同程度的缩小。33例患者在正中矢状面及冠状面上垂体柄均未见明确显示,7例表现为不连续的细线状。所有患者的垂体后叶均未见正常高信号,35例表现为垂体后叶高信号异位在第三脑室漏斗隐窝、垂体柄及下丘脑;5例表现为垂体后叶高信号消失,也未见异位的高信号。结论：PSIS患者在MRI上有特征性表现,结合临床激素水平可明确诊断。Objective： To investigate characteristic findings and diagnostic value of MRI in pituitary stalk interruption syndrome（PSIS）. Methods： Forty patients with PSIS were enrolled.Small field of view（FOV） MRl scanning and clinic hormone detection were performed in all the patients. Fluid attenuated inversion recovery（FLAIR） T1 WI with fat-suppression sequence was performed in all the cases, and appearances on FLAIR T1 WI and T2W1 were recorded.The shape of pituitary stalk and antehypophysis and the signal intensity of posthypophysis were analyzed simultaneously. Results：Growth hormone deficiency（GHD） was confirmed in all 40 cases by clinic hormone detection. The level of basal GH varied from 为 0.01-1.44 μg / L, the peak value under GH provocation was 0.024-1.750 μg / L; GH was absolute default in all patients.Thirty-eight cases were combined pituitary hormone deficiency（CPHD）,and 2 cases were isolated growth hormone deficiency（IGHD）. The height of antepituitary was in the range from 1.2 mm to 3.5 mm, and the average value was（2.6 ±1.3） mm.Pituitary stalk was absent on the image in 33 cases, and showed as linear and discontinuous stalk in the other 7 cases. The high signal intensity was invisible in normal position in all cases, and high signal intensity spot in the region of infudibular recess of third ventricle, pituitary stalk and hypothalamus were seen in 35 cases, while it could not be found anywhere in 5 patients. Conclusions： PSIS often shows characteristic appearance on MRI, and a definite diagnosis can be made by using MRI combined with clinic hormone detection.

关 键 词：垂体柄阻断综合征 生长激素 磁共振成像 

分 类 号：R58[医药卫生—内分泌]