Abstract
目的 探讨颅底型垂体瘤的CT、MRI影像特征.方法分析16例颅底型垂体瘤(skullbase-type pituitaryadenoma,SBPA)的CT、常规MRI表现,以及动态增强MRI与病理学资料;与9例颅底脊索瘤(chordoma of the skull base,CSB)比较,观察二者在CT、常规MRI征象和时间信号-曲线类型、强化峰值时间、平均强化速率方面的差异.结果SBPA和CSB的CT表现相似,鉴别困难.二者T1WI均为稍低信号;T2WI上SBPA为稍高信号,CSB为显著高信号,二者间差异具有非常显著性意义(P＜0.001).SBPA于T2WI高信号背景上散布高信号小泡影,小泡影与背景的T2WI信号差异具有非常显著性意义(P＜0.001),T1WI信号接近,其病理学基础是扩大的腺泡.SBPA的时间-信号曲线为快速强化和快速消退的双期曲线,强化峰值时间为(60±10)s,平均强化速率为(600±50)/min;CSB在5 min内呈持续强化的单一上升峰,强化峰值时间＞5 min,平均强化速率(40±5)/min.二者强化峰值时间和平均强化速率差异具有显著性意义(P＜0.01,P＜0.001).结论CT诊断SBPA价值有限,无鉴别意义.T2WI稍高信号背景上散布高信号小泡影是SBPA的特征性MRI征象,有定性诊断价值.动态增强MRI有助于SBPA与CSB的鉴别。
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