Rathke囊肿的MRI诊断与鉴别诊断.docVIP

Rathke囊肿的MRI诊断与鉴别诊断 　　【摘要】 目的：分析Rathke囊肿的MRI表现，提高Rathke囊肿的MRI诊断和鉴别诊断水平。方法：搜集经临床随访和手术病理诊断的12例Rathke囊肿患者的临床和MRI资料，所有病例均行MRI平扫，其中11例同时进行MRI增强扫描，分析囊肿的具体位置、大小、形态、边缘和MRI表现。结果：12例Rathke囊肿最大径均小于10 mm，位于鞍内10例，位于鞍上2例。囊肿边缘光滑锐利，11例形态规则，1例呈分叶状。MRI平扫上T1WI和T2WI呈多种不同信号组合，其中6例T1WI呈低信号和T2WI呈高信号，11例增强扫描后呈环形强化1例，未见强化10例。12例均未见囊内结节或囊底沉淀物征象。结论：鞍内Rathke囊肿的MRI表现较具有诊断特征，鞍上型Rathke囊肿较少见且常需要与鞍区其他囊性病变鉴别。 　　【关键词】 Rathke囊肿； MRI； 诊断； 鉴别诊断 　　【Abstract】 Objective：To analyze the MRI findings of Rathke’s cleft cyst and to improve the level of MRI diagnosis and differential diagnosis in rathke’s cleft.Method：The clinical and MRI data of 12 patients with Rathke’s cleft cyst proved by clinical follow-up and surgical pathology were collected.All patients received MRI plain scanning and 11 patients received contrast-enhanced scanning at the same time.The location，size，shape，margin and MRI findings of Rathke’s cleft cyst were analyzed.Result：The maximal diameter of the 12 rathke’s cleft cysts was less than 10 mm.There were 10 cysts in the intrasella and 2 cysts in the suprasellar.The margins of all cysts were clear.11 cysts were regular in shape and 1 cyst was lobular.There were diverse signals on T1WI and T2WI.The low signal on T1WI and high signal on T2WI were seen in 6 Rathke’s cleft cysts.After enhancement scan in 11 patients，only 1 cyst was enhanced peripherally and the other 10 cysts were not enhanced.The intracystic nodule and bottom sediment did not appear in all Rathke’s cleft cysts.Conclusion：The MRI appearance of intrasellar Rathke’s cleft cysts is more characteristic in diagnosis.However，the suprasellar Rathke’s cleft cyst is seldom seen，it often needs differential diagnosis from the other cystic lesions in the sellar region. 　　【Key words】 Rathke’s cleft cyst； MRI； Diagnosis； Differential diagnosis 　　First-author’s address：Yantian District People’s Hospital of Shenzhen City，Shenzhen 518081，China 　　doi：10.3969/j.issn.1674-4985.2015.32.024 　　Rathke囊肿是一种发生于鞍区的良性上皮性囊肿，又称垂体囊肿、上皮样囊肿和垂体胶样囊肿等