鞍旁海绵状血管瘤的MRI诊断及误诊分析  

Analysis of MRI Diagnosis and Misdiagnosis of Parasellar Cavernous Haemangioma

作　　者：吕秀花[1] 蔺新梅[2] 李陈[1] 王虹[1] 印弘[1] 

机构地区：[1]第四军医大学西京医院放射科,陕西西安710032 [2]解放军第十医院,甘肃武威733000

出　　处：《现代生物医学进展》2017年第26期5083-5086,共4页Progress in Modern Biomedicine

摘　　要：目的:分析鞍旁海绵状血管瘤MR影像特点及误诊原因,提高对该疾病的诊断及鉴别诊断水平。方法:收集我院经手术病理证实的13例鞍旁海绵状血管瘤,术前均行MRI平扫及增强扫描,5例行3D-ASL检查,分析其影像学资料。结果:9例表现为横向哑铃状,鞍旁大,鞍内小,病灶主体位于颈内动脉外侧,颈内动脉海绵窦段被病灶包绕;1例鞍旁与鞍内病灶大小相似,1例病灶主体位于颈内动脉内侧,2例病灶完全位于颈内动脉外侧;7例垂体显示不清,6例垂体受推移;6例T2W I表现为类似脑脊液的极高信号;仅5例行3D-ASL检查,病灶均呈低灌注。误诊9例,其中4例误诊垂体腺瘤,5例误诊脑膜瘤。结论:横向哑铃状、病灶主体位于颈内动脉外侧及T2W I类似脑脊液的极高信号是鞍旁海绵状血管瘤的典型影像特征。对于不典型病变,借助3D-ASL可以减少误诊,充分掌握MRI影像特征及鉴别诊断的要点,对提高临床术前诊断水平具有重要价值。Objective： To analyze the magnetic resonance imaging （MRI） features of parasellar cavernous haemangioma and improve the diagnosis and differential diagnosis accuracy. Methods： 13 patients with parasellar cavernous haemangioma were collected. All the patients were diagnosed by MRI and confirmed by pathology. Based on the pathologic findings, the MRI features were discussed. Results： 9 cases presented horizontal dumbbell. The lesions located in the parasellar were larger than the sella tureiea. The main body position of the lesions were centered lateral to the parasellar and eneasesed the intracavernous internal carotid artery （ICICA）. While, 1 cases were similar in size and shape. 1 case was located in the sella turcica. 2 cases was centered lateral to the ICICA. pituitary were detected obscurity in 7 cases and displaced in 6 cases, 6 cases appeared extremely high homogeneous intensity on T2-weighted images： as bright as cerebrospinal fluid signal. Only 5 cases underwent three-dimensional arterial spin labelling perfusion imaging （3D-ASL）. The lesions revealed marked hypoperfusion. The cases of misdiagnosis were 9, including 4 cpituitary adenomas and 5 meningiomas. Conclusions： The characteristics of MR images ofparasellar cavernous haemangioma were horizontal bottle gourd form, the main body position of the lesions were centered lateral to the parasellar and encasesed the （ICICA）, and their extremely high homogeneous intensity on T2-weighted images： as bright as cerebrospinal fluid signal. In cases that are equivocal, 3D-ASL were useful in differentiating cavernous haemangiomas from parasellar meningiomas, which could decrease mistaken diagnosis. Graspping the imaging feature and differential diagnosis were helpful for the diagnosis of this disease.

关 键 词：海绵状血管瘤 鞍旁 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.4[医药卫生—诊断学]