垂体腺瘤卒中与短T_(1)信号Rathke囊肿的临床及MRI特征比较  

Comparation of the clinical and MRI features between pituitary adenoma apoplexy and Rathke cleft cyst manifesting as short T_(1) signal

作　　者：张安林 陈英 ZHANG Anlin;CHEN Ying(Department of Radiology,the Afiliated Hospital of Panzhihua University,Panzhihua,Sichuan Province 617000,China;Department of Radiology,the People's Hospital of Chongqing Tongliang DListrict,Chongqing 400062,China)

机构地区：[1]攀枝花学院附属医院放射科,四川攀枝花617000 [2]重庆市铜梁区人民医院放射科,重庆400062

出　　处：《实用放射学杂志》2023年第7期1063-1066,共4页Journal of Practical Radiology

摘　　要：目的探讨垂体腺瘤卒中与短T_(1)信号Rathke囊肿的临床及MRI表现差异。方法比较52例垂体腺瘤卒中(腺瘤组)及50例T_(1)WI高信号Rathke囊肿(囊肿组)的临床及MRI特征并建立logistic回归模型,使用曲线下面积(AUC)评价其诊断效能。结果(1)临床特征:内分泌紊乱症状多见于囊肿组,垂体激素水平增高多见于腺瘤组,差异均有统计学意义(P<0.05);(2)MRI特征:腺瘤组病灶平均径线高于囊肿组;冠状位上腺瘤组以垂体柄偏移多见,囊肿组以垂体柄居中多见;腺瘤组信号多不均匀,囊肿组信号多较均匀;腺瘤组液-液平面、鞍旁结构受侵出现率较高,囊肿组囊内结节出现率较高,2组差异均有统计学意义(P<0.05);(3)logistic回归分析:垂体激素水平增高、病灶较大及冠状位上垂体柄偏移是垂体腺瘤卒中的独立预测因子,该模型预测垂体腺瘤卒中的准确率0.951,AUC0.990。结论垂体腺瘤卒中与短T_(1)信号Rathke囊肿有不同的临床及MRI特征,两者联合有助于提高2种疾病的诊断正确率。Objective To investigate the differential clinical and MRI features between pituitary adenoma apoplexy and Rathke cleft cyst manifesting as short T_(1) signal.Methods The clinical and MRI features of 52 patients with pituitary adenoma apoplexy(adenoma group)and 50 patients with Rathke cleft cyst manifesting as T_(1)WI high signal(cyst group)were compared.The logistic regression model was established by combining these parameters differed statistically between the two groups,and area under the curve(AUC)was used to evaluate its diagnostic performance.Results(1)Comparison of clinical features:endocrine disorders were more common in the cyst group,whereas increased pituitary hormone levels were more common in the adenoma group,and the differences were statistically significant(P<0.05);(2)Comparison of MRI features:the average size in adenoma group was higher than that in cyst group;pituitary stalk migration in coronal position was more common in the adenoma group,and pituitary stalk centralization was more common in cyst group;the signals in adenoma group were more uneven,while those in cyst group were more uniform;the fluid-fluid level and invasion of parasellar structures were more common observed in adenoma group,whereas intra-cystic nodules were more frequently seen in cyst group;the differences between the two groups were statistically significant(P<0.05).(3)Logistic regression analysis showed that increased pituitary hormone level,large lesion size and migration of pituitary stalk in coronal position were independent predictors of pituitary adenoma apoplexy.The accuracy rate was 0.951,and the AUC was 0.990 for this model.Conclusion Pituitary adenoma apoplexy and Rathke cleft cyst with short T_(1) high signal have different clinical and MRI features.Integrating these features may help to increase the diagnostic accuracy of the two diseases.

关 键 词：RATHKE囊肿 垂体腺瘤 磁共振成像 

分 类 号：R736.4[医药卫生—肿瘤] R445.2[医药卫生—临床医学]