摘要
目的 :探讨MR对海绵窦侵袭型垂体瘤的诊断价值 ,寻求建立一套海绵窦侵袭型垂体瘤的MR诊断系统。方法 :选取手术中已经确诊的 39例海绵窦侵袭型垂体瘤 ,同期 16 2例非侵袭型垂体瘤做对照 ,应用计算机分析冠状位MR上肿瘤与海绵窦的关系 ,包括海绵窦形态的改变、窦内间隙的改变以及肿瘤与颈内动脉海绵窦段的关系等 ,将相关的各个类型均做为拟诊标准分别计算各自的灵敏度 (Se)、特异度 (Sp)、阳性预告值 (PV +)、阴性预告值 (PV - )。依据医学统计学原理中的判别分析法进一步系统分析MR图像对于是否海绵窦侵袭型垂体瘤的诊断意义。结果 :肿瘤包绕颈内动脉 70 %确诊侵袭的意义最大 (PV +,10 0 % ) ,肿瘤超过颈内动脉外侧连线的诊断意义也较高 (PV +,86 1% ) ;如果肿瘤包绕颈内动脉的角度不到 2 0 %、肿瘤未超过颈内动脉内侧连线以及海绵窦内侧间隙未出现肿瘤则可以排除海绵窦侵袭的存在。同时应用判别分析法建立了一个海绵窦侵袭型垂体瘤及非海绵窦侵袭型垂体瘤的统计学判别计量数值表 ,从而完善了海绵窦侵袭型垂体瘤MR图像诊断系统。结论 :通过系统分析垂体瘤MRI的表现 ,能够比较准确的确立海绵窦侵袭型垂体瘤的诊断。
Objective:To define magnetic resonance (MR) imaging criteria for the diagnosis of pituitary adenoma with cavernous sinus invasion.Methods:The coronary MR images of sellar region obtained in 201 patients with pituitary adenoma and dealt with computer were reviewed retrospectively. The standard-of-reference criteria for invasion were the surgical findings. The tumor's involvement in cavernous sinus was analyzed systematically with computer in several groups. Based on them,the valuable factors for diagnosing the invasion of cavernous sinus was acquired and the efficacy of MR images was surged to approach with discriminant analysis.Results:If the encasement of the interior carotid artery was not less than 70%, it could ensure the invasion of cavernous sinus accurately. If the encasement was less than 20%, the tumor was not depictured in the medial venous compartment, or the tumor was not crossed the medial intercarotid line, we should give up the diagnosis of cavernous sinus invasion. Then, based on the discriminant analysis, we set up a discriminant metric numerical table for the diagnosis of cavernous sinus invasion.Conclusion:With systematically analysis of the coronary MR images, the image criteria for the invasion of cavernous sinus by pituitary adenoma was set up.
出处
《医学影像学杂志》
2004年第11期882-885,共4页
Journal of Medical Imaging
关键词
侵袭型垂体瘤
海绵窦
磁共振成像
统计学处理
Invasive pituitary adenoma
Cavernous sinus
Magnetic resonance imaging
Statistics process
