垂体柄病变的MRI影像与临床特征分析  

Pituitary stalk lesions associate with central diabetes insipidus:MR imaging and clinical features

作　　者：史红媛 建方方[2] 卞留贯[2] 孙青芳[2] 缪飞[3] SHI Hongyuan;JIAN Fangfang;BIAN Liuguan;SUN Qingfang;MIAO Fei(Department of Radiology,The First Affiliated Hospital with Nanjing Medical University,Nanjing 210009,China;Department of Neurology Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Radiology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210009 [2]上海交通大学医学院附属瑞金医院神经外科,上海200025 [3]上海交通大学医学院附属瑞金医院放射科,上海200025

出　　处：《医学影像学杂志》2023年第2期181-185,共5页Journal of Medical Imaging

基　　金：国家自然科学基金(编号:81701760);江苏省科学技术厅青年基金资助项目(编号:BK20171086)。

摘　　要：目的 探讨MRI在垂体柄病变影像诊断中的价值及限度。方法 选取并分析经病理证实的21例垂体柄病变的MRI特征和临床表现。结果 21例中生殖细胞瘤7例,朗格汉斯组织细胞增多症(langerhans cell histiocytosis, LCH)6例,淋巴细胞漏斗神经垂体炎(lymphocytic infundibuloneurohypophysitis, LINH)5例,颗粒细胞瘤2例,Erdheim-Chester病(ECD)1例。21例MRI表现为垂体柄不同程度增粗或肿块,以垂体柄上部为主,增强呈明显强化。病灶最大横径为(6.68±2.97) mm。17例垂体后叶高信号消失,1例神经垂体异位。21例患者均有中枢性尿崩症,其中13例患者出现垂体前叶功能减低,以继发性性腺功能减退最常见。结论 MRI可以早期发现垂体柄病变,但对肿瘤及炎性病变的定性诊断尚需进一步研究。Objective To analyze MR manifestations of pituitary stalk lesions and to evaluate the value of MRI. Methods Twenty-one patients with pathologically proven pituitary stalk lesions were enrolled in this study. MR imaging and clinical features were evaluated. Results 21 patients included germinoma(n=7), langerhans cell histiocytosis(LCH, n= 6), lymphocytic infundibuloneurohypophysitis(LINH, n=5), granulosa cell tumor(GCT, n=2) and Erdheim-Chester disease(ECD, n=1). On MRI, all patients showed thickening or mass-likeof the pituitary stalk with obvious enhancement. Most lesions located in the upper portion of the stalk. The average diameter of pituitary stalk lesion was(6.68±2.97) mm. Seventeen patients had loss of the posterior pituitary bright spot and the remaining one had ectopic neurohypophysis. All patients had central diabetes insipidus(CDI). Thirteen patients were found to have anterior pituitary hormone deficiency. Second hypogonadism was the most common endocrine deficiency. Conclusion MRI has important value in the early detection of pituitary stalk lesions, but differential diagnosis of neoplastic or inflammatory lesions involving the pituitary stalk needs further research.

关 键 词：垂体柄 神经垂体 中枢性尿崩症 磁共振成像 

分 类 号：R736.4[医药卫生—肿瘤] R445.1[医药卫生—临床医学]