Nagahata M, Hosoya T, Kayama T, Yamaguchi K
Department of Radiology, Yamagata University School of Medicine, Japan.
AJNR Am J Neuroradiol. 1998 Oct;19(9):1753-7.
The pattern of edema caused by craniopharyngiomas and other common suprasellar masses could be useful for determining the differential diagnosis of lesions in this region. The purpose of this study was to ascertain whether the pattern of edema spread on MR images can be used in the diagnosis of craniopharyngiomas.
The preoperative MR images in eight consecutive patients with craniopharyngiomas, 15 patients with large pituitary adenomas compressing the optic chiasm, and six patients with tuberculum sellae meningiomas were evaluated. All the patients were treated surgically at our hospital and a pathologic diagnosis was obtained. We analyzed the spread of edema surrounding the tumor on the coronal dual-echo fast spin-echo images and compared this finding with tumor location and size as seen on contrast-enhanced T1-weighted images.
Not only peritumoral edema but also edema spreading along the optic tracts was observed in five patients with craniopharyngiomas, one of whom also had edema within one optic nerve. The location of edema in the visual pathway was not always associated with the degree of visual disturbance. None of the patients with large pituitary adenomas or with tuberculum sellae meningiomas had such edema along the visual pathway.
Edema caused by craniopharyngiomas tends to spread along the optic tracts. It is a useful MR finding for distinguishing craniopharyngiomas from other common parasellar tumors.
颅咽管瘤及其他常见鞍上肿物所致水肿的模式可能有助于确定该区域病变的鉴别诊断。本研究的目的是确定磁共振成像（MR）上水肿扩散模式是否可用于颅咽管瘤的诊断。
对连续8例颅咽管瘤患者、15例压迫视交叉的大型垂体腺瘤患者及6例鞍结节脑膜瘤患者的术前MR图像进行评估。所有患者均在我院接受手术治疗并获得病理诊断。我们在冠状面双回波快速自旋回波图像上分析肿瘤周围水肿的扩散情况，并将这一发现与增强T1加权图像上所见的肿瘤位置和大小进行比较。
5例颅咽管瘤患者不仅观察到瘤周水肿，还观察到沿视束扩散的水肿，其中1例患者的一条视神经内也有水肿。视路中水肿的位置并不总是与视觉障碍程度相关。大型垂体腺瘤患者或鞍结节脑膜瘤患者均无沿视路的此类水肿。
颅咽管瘤所致水肿倾向于沿视束扩散。这是将颅咽管瘤与其他常见鞍旁肿瘤区分开来的一项有用的MR表现。
