鞍旁少见肿瘤的MRI诊断  

MRI Diagnosis of Rare Parasellar Tumors

作　　者：包佳怡 杨义文 胡春洪[1,2] BAO Jia-yi;YANG Yi-wen;HU Chun-hong(Department of Imaging Center,The First Affiliated hospital of Soochow University,Suzhou215000,Jiangsu Province,China;Institute of Imaging,Soochow University,Suzhou 215000,Jiangsu Province,China)

机构地区：[1]苏州大学附属第一医院放射科,江苏苏州215000 [2]苏州大学影像研究所,江苏苏州215000

出　　处：《中国CT和MRI杂志》2023年第3期4-5,11,共3页Chinese Journal of CT and MRI

摘　　要：目的分析几种少见类型鞍旁肿瘤MRI影像表现,探讨其MRI诊断及鉴别。方法收集15例鞍旁肿瘤的临床及MRI资料并进行回顾性分析,男性8例,女性7例,年龄37~74岁。15例病例均行MRI检查,扫描序列包括快速自旋回波T1WI、T2WI、DWI,其中14例行增强扫描。全部病例均经手术病理证实,其中神经鞘瘤4例、表皮样囊肿伴破裂1例、脊索瘤4例、垂体腺瘤2例、淋巴瘤1例、鼻咽癌1例、转移瘤1例(来源于鼻咽癌)、动脉瘤伴机化1例。结果(1)鞍旁神经鞘瘤常与桥小脑角区相连,病变常呈囊实性改变;(2)鞍旁表皮样囊肿内含脂质,增强一般不强化,高b值DWI呈境界清楚的高信号;(3)T2WI蜂窝状表现为鞍旁脊索瘤的特征性表现;(4)垂体窝内正常垂体消失可作为鞍旁垂体腺瘤的诊断依据;(5)发现鼻咽黏膜增厚、中耳乳突炎及颈部多发肿大淋巴结提示鼻咽癌的可能性大;(6)MRA可显示瘤体和载瘤动脉的关系,有助于提示鞍旁动脉瘤。结论部分鞍旁少见类型肿瘤有特征的MRI表现,结合DWI以及MRA检查有助于其鉴别诊断。Objective To explore the value of MRI in differential diagnosis of rare parasellar tumors by analyzing the MRI manifestations of different types of rare parasellar tumors.Methods The clinical manifestations and MRI characteristics of 15 rara parasellar tumors was analyzed retrospectively.There were 8 cases in men and 7 cases in women,aged between 37 and 74 years.MRI was performed in all 15 cases,and the scan sequences included fast spin-echo T1WI,T2WI,and DWI.Fourteen of these cases were enhanced.All cases were confirmed by surgical pathology,including 4 of schwannomas,1 of epidermoid cysts with broken,4 of chordomas(originating on slopes,involving parasellar),2 of pituitary adenomas,1 of lymphoma,1 of nasopharynx cancer,1 of metastic tumor(originating on nasopharynx cancer),1 of aneurysm(with organization).Results(1)Schwannomas of parasellar often connected to the cerebellopontine angle region,with lesions often showing cystic solid changes.(2)Epidermoid cysts of parasellar contain lipid and are generally non-enhancing,with high b-value DWI showing well-defined high signal.(3)T2WI foveal manifestations are characteristic of parasellar chordoma.(4)The disappearance of the normal pituitary gland in the pituitary fossa can be used as a diagnostic basis for parasympathetic pituitary adenoma.(5)The finding of thickened nasopharyngeal mucosa,middle ear mastoiditis and multiple enlarged lymph nodes in the neck suggest a high probability of nasopharyngeal cancer.(6)MRA can show the relationship between the aneurysm and the aneurysm-carrying artery,which can help suggest a parasternal aneurysm.Conclusion Some of the rare types of parasellar tumors have characteristic MRI manifestations,and the combination of DWI and MRA examination can help in their differential diagnosis.

关 键 词：鞍旁 肿瘤 磁共振成像 鉴别诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]