内分泌疾病影像诊断课件.ppt

* 垂体腺瘤是垂体最常见的原发肿瘤，占颅内肿瘤的10-15％，有3/4会有激素造成的症状－－功能性，1/4为非功能性 * 垂体腺瘤是垂体最常见的原发肿瘤，占颅内肿瘤的10-15％，有3/4会有激素造成的症状－－功能性，1/4为非功能性 垂体大小变化不明显，增强后对比明显，低强化 * * 增强后，中心有一个低信号区域 60s，有一个低强化结节； * * 垂体腺瘤是垂体最常见的原发肿瘤，占颅内肿瘤的10-15％，有3/4会有激素造成的症状－－功能性，1/4为非功能性 鞍底不规则，看不到鞍背 * * Lateral view of the sella turcica exhibits the findings of an expanding intrasellar mass, extending upward. There is asymmetrical remodeling of the floor resulting in a double floor, dorsal displacement of one side of the dorsum sellae, and upward and posterior displacement of a posterior clinoid process (arrow). The lamina dura of the sella is intact. This patient had a surgically proven chromophobe adenoma. * MRI是首选检查，术前和术后 向下压迫蝶鞍窦壁；中心有个坏死低信号区 * MRI是首选检查，术前和术后 * Because of their relatively tenuous blood supply, pituitary adenomas are prone to develop infarction or hemorrhage headache, vomiting, ophthalmoplegia,or visual loss * * Because of their relatively tenuous blood supply, pituitary adenomas are prone to develop infarction or hemorrhage headache, vomiting, ophthalmoplegia,or visual loss * * 腹部平片的作用仅限于观察肾上腺钙化。钙化通常是新生儿出血的后遗改变，在成人期多半吸收了。钙化经常在神经母细胞瘤中见到，偶尔也可见于成人的良性和恶性肿瘤。慢性肉芽肿性疾病，例如结核，常是肾上腺钙化的来源。 其原理是MIBG在化学结构上类似去甲肾上腺素，能被肾上腺髓质和嗜铬细胞瘤摄取。故对嗜铬细胞瘤检查有特异性，能鉴别肾上腺或肾上腺以外其他部位的肿瘤是否为嗜铬细胞瘤。具有安全、特异和准确率高的优点 当有上腹大肿块时，常常不易确定它是来源于肝，肾还是其它的后腹膜结构。在这种情况下，证明肿瘤的主要血供是源于肾上腺动脉是很有用的。肾上腺静脉造影比动脉造影更常用，通过取血样分析，可以定位小的功能性肿瘤。 * * * Both adrenal glands (arrows) are symmetrically enlarged * * A homogeneous, rounded mass is detected in the right adrenal gland. 光滑，密度低 * Adenoma on chemical shift imaging. A. The in-phase image reveals a small, rounded homogeneous left adrenal mass. B. The loss in signal intensity on the opposed phase image indicates the presence of lipid. * * * A left adrenal mass (P) is identified on this unenhanced abdominal CT examination. * (a) Contrast-enhanced axial CT scan demonstrates an enlarged right adrenal gland with internal calcifications (arrow). (b) Coronal reformatted image from the axial data set demonstrates the r