颅内非鞍区肿瘤患者腺垂体功能与垂体形态的相关研究  

The correlational study between function and morphological change of pituitary gland in the patients with non-sellar intracranial tumors

作　　者：鹿松松 裴家生[2] 黄银兴[2] 薛亮[2] 张尚明[2] 赵清爽[2] 王守森[2] 

机构地区：[1]中国科技大学附属第一医院,安徽合肥230000 [2]福州总医院神经外科,福建福州350025

出　　处：《中华神经外科疾病研究杂志》2018年第1期55-59,共5页Chinese Journal of Neurosurgical Disease Research

基　　金：南京军区福州总医院创新团队基金资助项目(201407)

摘　　要：目的探讨颅内非鞍区肿瘤患者腺垂体功能状态及其与垂体形态改变之间的关系。方法收集南京军区福州总医院神经外科自2014年5月至2015年3月收治的颅内非鞍区肿瘤患者临床资料,根据术前血清垂体激素测定结果对腺垂体功能进行判断。在垂体MRI图像上,测量垂体矢状位前后径、矢状高径及冠状宽径,根据MRI正中矢状位上垂体形态特点将将垂体分为平坦型、凹陷型和隆起型。对腺垂体功能状态与其形态、径线改变之间的关系进行分析研究。结果 83例患者,术前30例存在腺垂体功能低下。单轴低下23例;多轴低下7例。腺垂体功能正常组及功能低下组,在垂体形态和径线(矢状位前后径、矢状位高径和冠状宽径)上的差异无统计学意义(P>0.05)。肿瘤位于硬膜下脑实质外的患者,其垂体矢状高径明显低于脑实质内组及脑室内组,差异有统计学意义(P<0.05);同时该分组患者垂体呈凹陷型的发生率高于另两组,差异具有统计学意义(P<0.05)。结论腺垂体功能低下在颅内非鞍区肿瘤患者中具有高的发病率,垂体形态及径线改变与功能之间无明确关系,但硬膜下脑实质外肿瘤(如脑膜瘤、听神经瘤)组中,垂体矢状位高径低于其他组,同时垂体以凹陷型多见。Objective The relationship between the function and morphological change of pituitary gland in the patients with non-sellar intracranial tumors were investigated. Methods The patients with intracranial non-sellar tumors between May 2014 and March 2015 in our department were included retrospectively. The status of pituitary function was assessed by the level of pre-operative serum hormone. Regarding the size and morphology of the pituitary, the sellar region Tl WI median sagittal plane was used to measure the pituitary anterior-posterior diameter, sagittal height, and coronal pituitary width. The pituitary morphology was categorized into the enlarged type, depressed type, and flat type on the basis of the pituitary superior border. The function and morphological changes of pituitary in the patients with non-sellar intracranial tumors were studied in the study. Results In the study, 83 cases were included. There were 30 cases of pre-operative pituitary insufficiency including 23 cases of deficiency in one pituitary axe and 7 cases of multiaxial deficiency. There was no statistically significant differences between function and morphological change of pituitary gland in the patients with non-sellar intracranial tumors （P 〉0. 05）. Patients with tumors located in subdural interparenchyma had a lower sagittal height with statistically significant difference （P 〈0.05）. At the same time, the incidence of depressed type-pituitary was higher than the other two groups with statistically significant difference （P 〈 0. 05）. Conclusion The hypopituitarism in the patients with non-sellar intracranial tumors has a higher morbidity. There is no definite relationship between the function and morphological change of pituitary gland. But in subdural parenchymal tumors （e. g., meningioma, acoustic neuroma）, pituitary sagittal height is lower than the other tumors and the depressed type of pituitary is common in terms of murphology.

关 键 词：颅内非鞍区肿瘤 腺垂体功能低下 垂体形态 磁共振成像 

分 类 号：R739[医药卫生—肿瘤]