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[目的]分析垂体微腺瘤磁共振图像假阴性表现的原因,探讨对这类微腺瘤的诊断方法。[方法]回顾性分析经手术证实垂体微腺瘤患者54例,男9例,女45例,患者平均年龄34.5岁(16~57岁),所有患者手术前均行磁共振平扫及动态增强。分析平扫与增强检查均为假阴性表现的垂体微腺瘤的特点,探讨磁共振对这类微腺瘤的诊断方法。[结果]经手术证实垂体微腺瘤患者54例中正常垂体形态的微腺瘤18例,其中12例形态与信号均正常,动态增强检查后18例垂体表现为正常形态的微腺瘤中14例可以明确诊断,4例磁共振平扫及增强检查均为阴性,该4例患者3~6个月后复查磁共振均明确诊断。[结论]部分垂体微腺瘤患者垂体形态可以表现为正常,甚至表现为形态与信号均正常,动态增强可以提高垂体微腺瘤检出率,应列为常规检查,对于临床高度怀疑垂体微腺瘤而磁共振平扫及增强均表现为正常的患者,结合临床表现、相关化验结果并定期复查可以进一步提高垂体微腺瘤的检出率。
[Objective] To analyze the causes of false negative results of magnetic resonance imaging of pituitary microadenomas and to explore the diagnostic methods of such microadenomas. [Methods] Retrospective analysis of 54 cases of pituitary adenoma confirmed by surgery, 9 males and 45 females, the average age of patients 34.5 years (16 to 57 years), all patients underwent MRI before surgery and dynamic enhancement . Analysis of plain scan and enhanced examination were false negative findings of the characteristics of pituitary microadenomas to explore the diagnosis of such micro-adenoma magnetic resonance method. [Results] 18 cases of pituitary adenoma were confirmed by operation in 54 cases of pituitary adenoma. The morphology and signal of 12 cases were all normal. The dynamic changes of 18 cases of pituitary adenocarcinoma showed normal morphology in 14 cases Cases can be a clear diagnosis, 4 cases of magnetic resonance plain scan and enhanced examination were negative, the 4 patients 3 to 6 months after the re-examination of MR were confirmed. [Conclusion] The pituitary morphology in some pituitary microadenomas may be normal, even the morphology and signal are normal. The dynamic enhancement can improve the detection rate of pituitary microadenomas. It should be listed as a routine examination. For the clinical suspicion of pituitary gland Tumor and MRI plain scan and enhancement showed normal patients, combined with clinical manifestations, related laboratory results and regular review can further improve the detection rate of pituitary microadenomas.