Sartoretti-Schefer S, Wichmann W, Aguzzi A, Valavanis A
Department of Neuroradiology, University Hospital of Zürich, Switzerland.
AJNR Am J Neuroradiol. 1997 Jan;18(1):77-87.
To determine MR criteria for differentiating adamantinous from squamous-papillary craniopharyngiomas.
The MR imaging features of 42 histologically proved craniopharyngiomas (25 adamantinous, 15 squamous-papillary, and two mixed subtypes) were examined with multiplanar T2-weighted and noncontrast and contrast-enhanced T1-weighted imaging. Differences in the mR features of both subtypes were evaluated retrospectively.
The adamantinous craniopharyngioma is a mixed solid-cystic or mainly cystic lobulated suprasellar or intrasellar/suprasellar tumor occurring in children and adults, typically with large nonenhancing hyperintense cysts on T1-weighted images. The squamous-papillary craniopharyngioma is a predominantly solid or mixed solid-cystic suprasellar tumor occurring in adults, appearing as a hypointense cyst on noncontrast T1-weighted images. Calcifications and recurrent tumors are more often observed in adamantinous tumors but can be seen in squamous-papillary tumors as well. Statistically significant parameters useful for differentiating the two tumor subtypes are the encasement of vessels, the lobulated shape, and the presence of hyperintense cysts in adamantinous tumors, and the round shape, the presence of hypointense cysts, and the predominantly solid appearance in squamous-papillary tumors.
Craniopharyngiomas can be divided into two clinically, histologically different subtypes, which suggests a different pathogenesis of these two types of tumor.
确定鉴别造釉细胞瘤型与鳞状乳头型颅咽管瘤的磁共振成像（MR）标准。
对42例经组织学证实的颅咽管瘤（25例造釉细胞瘤型、15例鳞状乳头型和2例混合型）的MR成像特征进行多平面T2加权成像、非增强及增强T1加权成像检查。回顾性评估两种亚型MR特征的差异。
造釉细胞瘤型颅咽管瘤是一种发生于儿童和成人的混合实性-囊性或主要为囊性分叶状鞍上或鞍内/鞍上肿瘤，在T1加权图像上通常有大的无强化高信号囊肿。鳞状乳头型颅咽管瘤是一种主要发生于成人的实性或混合实性-囊性鞍上肿瘤，在非增强T1加权图像上表现为低信号囊肿。钙化和复发性肿瘤在造釉细胞瘤型肿瘤中更常见，但在鳞状乳头型肿瘤中也可见。有助于鉴别这两种肿瘤亚型的具有统计学意义的参数包括：造釉细胞瘤型肿瘤中血管包绕、分叶状形态及高信号囊肿的存在，以及鳞状乳头型肿瘤中的圆形形态、低信号囊肿的存在及主要为实性外观。
颅咽管瘤可分为两种临床和组织学不同的亚型，提示这两种肿瘤类型的发病机制不同。
