MRI同层动态增强在垂体微腺瘤诊断中应用价值.docVIP

MRI同层动态增强在垂体微腺瘤诊断中应用价值 　【摘要】 目的：观察脑垂体微腺瘤患者MRI动态增强扫描在垂体微腺瘤诊断中的价值。方法：选择垂体微腺瘤血PRL均gt;40 ng/mL的患者23例。采用美国GE公司生产的Signa EXCITE HD1.5T超导型磁共振扫描仪，行垂体动态增强扫描时，用对比剂钆喷酸葡胺，其剂量为0.1 mmol/kg，采用快速自旋回波序列。结果：常规平扫23例中，有15例可见异常信号改变，占66%；而动态增强扫描后有21例可见正常垂体腺、漏斗、海绵窦逐一明显强化，微腺瘤则尚未强化仍呈低信号区，形成鲜明对比的图像特征，占92%。平扫垂体一侧饱满或T1、T2未见异常信号者并不干扰此特征的出现。结论：MRI动态增强扫描具有特征性征象，在冠状位上对垂体微腺瘤最具有诊断意义。 【关键词】 垂体肿瘤；腺瘤；磁共振成像;诊断 ［ABSTRACT］ Objective: To observe the value of non dynamic enhanced MRI in the diagnosis of pituitary microadenoma. Methods: 23 pituitary microadenoma patients with PRLgt;40 ng/mL were scanned with Signa EXCITE HD1.5T superconduction magnetic resonance imaging scanner manufactured by GE company in U.S.A. With 0.1mmoL/kg magnevist solution as contrast agent, applied Turbo Spin Echo to employ non dynamic enhanced MRI. Results: Abnormal signal showed in 15 cases by routine plain scan (66%), while images of normal pituitary gland, infundibulum, and cavernous sinus showed obviously strengthened signals in 21 cases by non dynamic enhanced MRI (92%), with low signal area of microadenoma, forming evident image characters. These characters appeared even when one side of pituitary gland was full as plain scanning or when abnormal signals didn’t show in T1, T2. Conclusion: Non dynamic enhanced MRI has obvious character, and plays a role in diagnosis of pituitary microadenoma in coronal position. ［KEY WORDS］ Hypophyseal tumor; Adenoma; MRI; Diagnosis 垂体微腺瘤是指直径小于1 cm而有异常内分泌功能的垂体腺瘤。近年来由于MRI的应用，其高对比度，高分辨率，多方位，多参数成像等优越性使垂体微腺瘤检出率不断提高。为探讨MRI动态增强扫描技术在诊断垂体微腺瘤上的表现及价值，现将我院动态增强扫描技术诊断垂体微腺瘤的有关体会报告如下。 1 资料与方法 1.1 一般资料 选取2006年10月～2007年8月行MRI动态增强扫描的脑垂体微腺瘤患者23例。年龄15～49岁，平均32岁。其中女性21例，均有停经、月经紊乱、泌乳史，6例有头痛、头晕史。男性2例，均为成人，1例有性功能低下、不育史，1例为乳房发育。血PRL均gt;40 ng/mL。 1.2 方法 MRI检查采用美国GE公司的Signa EXCITE HD1.5T超导型磁共振扫描仪，颅脑专用线圈，头颅位置一定要摆正。自旋回波成像序列，常规做垂体冠状位T1WI，T2WI和矢状位T1WI扫描，然后行垂体动态增强扫描。对比剂选用钆喷酸葡胺，其剂量为0.1 mmol/kg，选用快速自旋回波序列。 　 序列应用技术与技巧：（1）垂体成像时的薄层扫描：垂体微腺瘤为3 mm以下无间隔扫描，应注意在颅颈交界区使用饱和技术，以消除颅内动脉搏动伪影。（2）垂体成像后处理：