磁共振扩散张量成像对垂体腺瘤所致的视路损伤的相关性研究进展  

Progress on the Correlation of MRI Diffusion Tensor on Visual Path Damage Caused by Pituitary Tumors

作　　者：钟琴 陈武标 刘碧华 庞燕华 ZHONG Qin;CHEN Wubiao;LIU Bihua;PANG Yanhua(Guangdong Medical University,Zhanjiang 524000,China;不详)

机构地区：[1]广东医科大学,广东湛江524000

出　　处：《中国医学创新》2022年第13期181-185,共5页Medical Innovation of China

摘　　要：垂体腺瘤是鞍区常见病灶,起源于垂体前叶的细胞,局限于蝶鞍的并且直径≤10 mm者为微腺瘤,直径>10 mm者为大腺瘤。垂体腺瘤患者逐渐出现视野缺损和视力丧失,以双眼颞侧偏盲为主,是垂体性腺瘤向上生长,超过了蝶鞍,压迫其上方的视交叉的最重要的临床标志。普通磁共振成像虽然能观察病灶的形态、大小及其与周围软组织的关系,但无法检测出视路的功能变化和细小结构的改变。扩散张量成像(DTI)通过水分子在组织中的弥散各向异性,跟踪神经纤维的走向,重建整个视觉通路,判断其连续性和完整性,可作为检测视觉通路损伤的客观工具,结合MRI常规序列,对肿瘤术前定性、定位诊断,术中病灶切除范围,术后判断组织残留/复发等方面均有重要作用。本文对磁共振扩散张量对垂体腺瘤所致的视路损伤的相关性研究进展做一综述。Pituitary adenomas are common lesions in the sellar area,originating from cells in the anterior pituitary gland.Those confined to the sella with a diameter≤10 mm are microadenomas,and those with a diameter>10 mm are large adenomas.Patients with pituitary adenomas gradually appear visual field defects and vision loss,mainly temporal hemianopia in both eyes,which is the most important clinical sign of pituitary adenomas growing upwards,surpassing the sella,and oppressing the optic chiasm above it.Although ordinary magnetic resonance imaging can observe the shape and size of the lesion and its relationship with the surrounding soft tissues,it cannot detect the functional changes of the visual pathway and the changes of fine structures.Diffusion tensor imaging(DTI)in the organization by water molecules diffusion anisotropy,tracking of nerve fibers,rebuilding the visual pathways,determine the continuity and integrity of the visual pathway injury objective tools can be used as detection,combined with routine MRI sequence,the tumor preoperative qualitative,positioning diagnosis and intraoperative lesion resection range,it plays an important role in determining tissue residual/recurrence after operation.This article reviews the research progress of the correlation between the MRI diffusion tensor and the visual path damage caused by pituitary adenomas.

关 键 词：垂体腺瘤 磁共振扩散张量 磁共振成像 视觉通路 轴突变性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R736.4[医药卫生—诊断学]