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目的 探讨颅底型垂体瘤的CT、MRI影像特征。方法 分析 16例颅底型垂体瘤 (skullbase typepituitaryadenoma,SBPA)的CT、常规MRI表现 ,以及动态增强MRI与病理学资料 ;与 9例颅底脊索瘤 (chordomaoftheskullbase ,CSB)比较 ,观察二者在CT、常规MRI征象和时间信号 曲线类型、强化峰值时间、平均强化速率方面的差异。结果 SBPA和CSB的CT表现相似 ,鉴别困难。二者T1WI均为稍低信号 ;T2 WI上SBPA为稍高信号 ,CSB为显著高信号 ,二者间差异具有非常显著性意义 (P <0 0 0 1)。SBPA于T2 WI高信号背景上散布高信号小泡影 ,小泡影与背景的T2 WI信号差异具有非常显著性意义 (P <0 0 0 1) ,T1WI信号接近 ,其病理学基础是扩大的腺泡。SBPA的时间 信号曲线为快速强化和快速消退的双期曲线 ,强化峰值时间为 (6 0± 10 )s ,平均强化速率为 (6 0 0± 5 0 ) /min ;CSB在 5min内呈持续强化的单一上升峰 ,强化峰值时间 >5min ,平均强化速率 (4 0± 5 ) /min。二者强化峰值时间和平均强化速率差异具有显著性意义 (P <0 0 1,P <0 0 0 1)。结论 CT诊断SBPA价值有限 ,无鉴别意义。T2 WI稍高信号背景上散布高信号小泡影是SBPA的特征性MRI征象 ,有定性诊断价值。动态增强MRI有助于SBPA与CSB的鉴别。
Objective To investigate the CT and MRI features of skull base pituitary tumor. Methods CT, routine MRI findings and dynamic contrast-enhanced MRI and pathology data of 16 cases of skullbase type pituitaryadenoma (SBPA) were analyzed. Compared with 9 cases of chordomahesheskullbase (CSB) , Conventional MRI signs and time signal curve type, peak-to-peak time, and average enhancement rate. Results The CT findings of SBPA and CSB were similar and difficult to identify. Both T1WI were slightly lower signal; T2WI SBPA is slightly higher signal, CSB was significantly higher signal, the difference between the two has a very significant (P <0.01). SBPA scatters high-signal small bubbles on T2 WI high signal background, and the difference of T2 WI signal between small bubble and background is very significant (P <0.01). The signal of T1WI is close and the pathological basis of SBPA is enlarged acinar . The time course of SBPA was a two-phase curve of rapid and rapid subsidence with peak intensifying time of (60 ± 10) s and average strengthening rate of (6 0 0 ± 5 0) / min. CSB continued to strengthen within 5 min Of the single rising peak, strengthening the peak time> 5min, the average strengthening rate (40 ± 5) / min. There was a significant difference between the two intensified peak time and the average enhancement rate (P <0.01, P <0.01). Conclusion CT diagnosis of SBPA is of limited value and has no significance. The distribution of high signal small bubbles on the slightly higher signal background of T2 WI is a characteristic MRI sign of SBPA, which has the value of qualitative diagnosis. Dynamic enhanced MRI contributes to the identification of SBPA and CSB.