Department of Radiology, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Beitou District, Taipei, 11217, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Pituitary. 2023 Aug;26(4):393-401. doi: 10.1007/s11102-023-01326-3. Epub 2023 May 25.
Large Rathke's cleft cysts (LRCCs) and cystic craniopharyngiomas (CCPs) arise from the same embryological origin and may have similar MR presentations. However, the two tumors have different management strategies and outcomes. This study was designed to evaluate the clinical and imaging findings of LRCCs and CCPs, aiming to evaluate their pretreatment diagnosis and outcomes.
We retrospectively enrolled 20 patients with LRCCs and 25 patients with CCPs. Both tumors had a maximal diameter of more than 20 mm. We evaluated the patients' clinical and MR imaging findings, including symptoms, management strategies, outcomes, anatomic growth patterns and signal changes.
The age of onset for LRCCs versus CCPs was 49.0 ± 16.8 versus 34.2 ± 22.2 years (p = .022); the following outcomes were observed for LRCCs versus CCPs: (1) postoperative diabetes insipidus: 6/20 (30%) versus 17/25 (68%) (p = .006); and (2) posttreatment recurrence: 2/20 (10%) versus 10/25 (40%) (p = .025). The following MR findings were observed for LRCCs versus CCPs: (1) solid component: 7/20 (35%) versus 21/25 (84%) (p = .001); (2) thick cyst wall: 2/20 (10%) versus 12/25 (48%) (p = .009); (3) intracystic septation: 1/20 (5%) versus 8/25 (32%) (p = .030); (4) snowman shape: 18/20 (90%) versus 1/25 (4%) (p < .001); (5) off-midline extension: 0/0 (0%) versus 10/25 (40%) (p = .001); and (6) oblique angle of the sagittal long axis of the tumor: 89.9° versus 107.1° (p = .001).
LRCCs can be differentiated from CCPs based on their clinical and imaging findings, especially their specific anatomical growth patterns. We suggest using the pretreatment diagnosis to select the appropriate surgical approach and thus improve the clinical outcome.
大型 Rathke 裂隙囊肿（LRCC）和囊性颅咽管瘤（CCP）起源于相同的胚胎起源，可能具有相似的 MRI 表现。然而，这两种肿瘤的管理策略和结果不同。本研究旨在评估 LRCC 和 CCP 的临床和影像学表现，旨在评估其术前诊断和结果。
我们回顾性纳入了 20 例 LRCC 患者和 25 例 CCP 患者。两种肿瘤的最大直径均大于 20mm。我们评估了患者的临床和 MRI 表现，包括症状、管理策略、结果、解剖生长模式和信号变化。
LRCC 组与 CCP 组的发病年龄分别为 49.0±16.8 岁和 34.2±22.2 岁（p=0.022）；LRCC 组与 CCP 组的以下结果如下：（1）术后尿崩症：6/20（30%）与 17/25（68%）（p=0.006）；（2）治疗后复发：2/20（10%）与 10/25（40%）（p=0.025）。LRCC 组与 CCP 组的以下 MRI 表现如下：（1）实性成分：7/20（35%）与 21/25（84%）（p=0.001）；（2）厚囊壁：2/20（10%）与 12/25（48%）（p=0.009）；（3）囊内分隔：1/20（5%）与 8/25（32%）（p=0.030）；（4）雪人形：18/20（90%）与 1/25（4%）（p<0.001）；（5）中线外延伸：0/0（0%）与 10/25（40%）（p=0.001）；（6）肿瘤矢状长轴的倾斜角度：89.9°与 107.1°（p=0.001）。
LRCC 可基于其临床和影像学表现与 CCP 相鉴别，尤其是其特定的解剖生长模式。我们建议使用术前诊断来选择合适的手术方法，从而改善临床结果。
