Song Chao-qiang, Ren Xiao-hui, Sui Da-li, Lin Song, Zhang Yan
Department of Neurosurgery, Daxing People's Hospital, Beijing 102600, China.
Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing 100050, China. Email:
Zhonghua Yi Xue Za Zhi. 2013 Dec 3;93(45):3610-3.
To explore the iconographic differences for pituitary adenoma, craniopharyngioma and Rathke cleft cyst involving both intrasellar and suprasellar regions.
A total of 99 eligible pathologically confirmed patients (pituitary adenoma, n = 49; craniopharyngioma, n = 35; Rathke cleft cyst, n = 24) were selected during January 2008 and January 2012. The following characteristics were evaluated: (1) calcification or not and density of tumor on computed tomography (CT); (2) shape, size, extent and component characteristics, signal intensities of solid portions on T2-weighted images, signal intensities of cystic portions on T1-weighted images and enhancement patterns of solid portions and cyst walls and complicated hydrocephaly or not. A flowchart for differential diagnosis for three tumors was constructed based on statistical analysis of the results.
A snowman shape, solid characteristics and homogeneous enhancement of solid portion were more common in pituitary adenomas; a lobulated shape, third ventricle compression by superior tumor extension, mixed solid and cystic characteristics, reticular enhancement of solid portion, calcification on CT scan and complicated hydrocephalus were more common in craniopharyngioma; an ovoid shape, small tumor size, cystic characteristics and none or thin cyst wall enhancement were more common in Rathke cleft cysts.
The above iconography characteristics are helpful in the differential diagnosis of three tumors involving both intrasellar and suprasellar regions.
探讨累及鞍内和鞍上区域的垂体腺瘤、颅咽管瘤和拉克氏囊肿的影像学差异。
选取2008年1月至2012年1月期间99例经病理证实的符合条件的患者（垂体腺瘤49例；颅咽管瘤35例；拉克氏囊肿24例）。评估以下特征：（1）计算机断层扫描（CT）上肿瘤的钙化情况及密度；（2）形状、大小、范围及成分特征、T2加权图像上实性部分的信号强度、T1加权图像上囊性部分的信号强度、实性部分及囊壁的强化方式以及是否合并复杂性脑积水。根据结果的统计分析构建三种肿瘤的鉴别诊断流程图。
垂体腺瘤多表现为雪人状、实性特征及实性部分均匀强化；颅咽管瘤多表现为分叶状、肿瘤向上延伸压迫第三脑室、实性和囊性混合特征、实性部分网状强化、CT扫描有钙化及合并复杂性脑积水；拉克氏囊肿多表现为椭圆形、肿瘤体积小、囊性特征及无强化或囊壁薄强化。
上述影像学特征有助于累及鞍内和鞍上区域的三种肿瘤的鉴别诊断。
