协和医学杂志

2011, v.2(03) 222-226

[打印本页] [关闭]
本期目录(Current Issue) | 过刊浏览(Past Issue) | 高级检索(Advanced Search)

垂体大腺瘤经蝶术后鞍区磁共振影像学表现
Magnetic Resonance Imaging of Sella after Transsphenoidal Resection of Pituitary Macroadenoma

李明利;张建;刘洋;金征宇;
LI Ming-li1, ZHANG Jian2, LIU Yang3, JIN Zheng-yu1 1Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China 2Imaging Center of First People's Hospital of Xinjiang Aksu, Aksu 843000, Xinjiang, China 3Department of Radiology of CT,Changji Hospital of Traditional Chinese Medicine, Changji 831100, Xinjiang, China

摘要(Abstract):

目的提高对垂体大腺瘤经蝶入路术后磁共振成像(magnetic resonance imaging,MRI)表现的认识,探讨术后首次影像随访的合理时机。方法回顾性分析40例垂体大腺瘤患者的临床资料和影像学资料,所有病例均有术前和术后至少2次不同时间点(1周内、3个月、6个月、1年)的MRI资料。结果根据术前资料分为非侵袭性大腺瘤(24例)和侵袭性大腺瘤(16例),术后11例见肿瘤残留,均为侵袭组。术后早期(1周内)鞍区仍可见软组织影,高度较术前有不同程度的下降;术后填充物在增强图像上无强化;残留肿瘤组织轻度强化,而残存垂体明显强化。术后中期(3个月)填充物明显或完全吸收,垂体常塌陷,残留垂体显著强化,且有不同程度的复张;残留肿瘤清晰度与早期MRI表现无明显差别。术后晚期(6个月、1年)影像改变与中期比较多无明显变化。蝶窦内炎症吸收缓慢,多数在术后6个月以上仍存在。肿瘤复发多出现在手术1年后,表现为残留肿瘤增大(2例)和新出现软组织影(1例)。结论垂体瘤术后不同时间段MRI表现有不同的特点,熟悉这些特点可更好地为临床诊治作出准确的评价。非侵袭性大腺瘤术后3个月复查足以满足临床需要;对术后有残留的侵袭性大腺瘤,术后早期或中期复查均可显示残留肿瘤。
Objective To summarize the magnetic resonance imaging (MRI) features of sella after transsphenoidal resection of pituitary macroadenoma, and explore the rational opportunities for the first radiological follow-up. Methods The clinical data and preoperative and postoperative MRI of 40 patients with macroadenoma were retrospectively analysed. The postoperative MRI was performed at early period (within 1 week),medium period(about 3 month), or later period (after 6 months or 1 year). Results Patients were divided into two groups based on preoperative data: invasive macroadenoma group (n=16) and noninvasive macroadenoma group (n=24). Residual tumors (n=11) were only found in the invasive macroadenoma group during the radiological follow-up. During the early period of postoperative follow-up, pituitary mass can still be found in soft tissue, with the heights decreased in varying degrees compared with those of the preoperative mass. The implanted material showed no enhancement on post-contrast MRI. The residural tumors showed mild to middle enhancement, while the residual pituitary gland showed apperent enhancement. During the medium period of postoperative follow-up, the implanted material was obviously or completely absorbed; the pituitary glands often collapsed, while the residual pituitary glands showed remarked enhancement. The re-expansion of the gland was found in some cases. The residural tumors were shown clearly, and the visibility of these residural tumors were not apparently different from those in the early period. The MRI features in the later were similar to those in the medium period. The inflammation of sphenoid sinus were absorbed slowely, and was still present after 6 months after surgery in most cases. Tumor recurrences were found in three patients one year later after the surgury, shown as the increased residural tumors (n=2), and newly developed soft tissue (n=1). Conclusions The MRI features differ at different time points after transsphenoidal resection of pituitary macroadenoma. For noninvasive macroadenoma, an MRI follow-up 3 months after surgery was appropriate and sufficient. For invasive macroadenoma, however, postoperative residual tumors may be found during earlyand medium-period follow-up.

关键词(KeyWords): 垂体大腺瘤;经蝶术后,磁共振成像;随访
pituitary macroadenoma; transsphenoidal resection, magnetic resonance imaging; follow-up

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 李明利;张建;刘洋;金征宇;
LI Ming-li1, ZHANG Jian2, LIU Yang3, JIN Zheng-yu1 1Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China 2Imaging Center of First People's Hospital of Xinjiang Aksu, Aksu 843000, Xinjiang, China 3Department of Radiology of CT,Changji Hospital of Traditional Chinese Medicine, Changji 831100, Xinjiang, China

Email:

DOI:

参考文献(References):

扩展功能
本文信息
服务与反馈
本文关键词相关文章
本文作者相关文章
中国知网
分享