摘要
目的观察垂体大腺瘤手术前后垂体后叶高信号的变化以及和尿崩症的关系。方法92例垂体大腺瘤患者根据术前MRIT1像垂体后叶是否显示高信号分成两组,分别比较两组的性别、年龄、肿瘤大小以及术后垂体后叶高信号出现的情况,同时比较手术后长期尿崩症出现和垂体后叶高信号显示的关系。结果92例中有60例(65.2%)显示垂体后叶高信号,32例(34.8%)未显示。肿瘤大小和垂体后叶高信号的出现有显著性差异(P=0.002),大腺瘤(直径1～3cm)出现和不出现的比例为40:10,而巨大腺瘤(直径﹥3cm)的比例为为20:22;垂体后叶高信号可见组中术后有5例消失,而垂体后叶高信号不可见组中有12例在术后显示。术后长期尿崩5例,其中4例垂体后叶高信号在术后无显示,与术后垂体后叶高信号显示的病例有显著性差异。结论垂体大腺瘤垂体后叶高信号的显示对于评价神经垂体的功能有帮助,肿瘤体积越大垂体后叶高信号出现的比例越小,术后垂体后叶高信号缺失者发生尿崩症的比例较高。
Objective To evaluate the disappearance or relocation patterns of posterior pituitary bright spot （PPBS） in large pituitary adenomas and relation to diabetes insipidus （DI）. Methods ninety-two patients with large adenoma were classified into PPBS-visible and PPBS-invisible groups on the basis of findings at preoperative T1-weighted magnetic resonance （MR） imaging. The large adenoma were classified into macro adenoma （diameter 1-3cm） and giant adenoma （ 〉 3cm）. Gender, age and PPBS changes after operation were compared. Post operation persisting DI was also analyzed based on PPBS-visible and tumor size. Results The PPBS-visibte group included 60 patients （65.2%） and 32 while patiend （34.8%） were in PPBS-invisble group find PPBS. There were no significant difference of gender and age between two groups. PPBS most commonly occurred in 40 patients with macro adenoma （40 of 50）. In giant adenoma occurred in 20 （20 of 42）. Postoperatively, 5 patients, in PPBS-invisible group became invisible.. The PPBS-invisible group included 12 （37.5%） patients became visible. Five patients developed postoperative permanent diabetes insipidus. In while four patients were PPBS-invisible in post operation MRI. It has significant difference. The tumor size and PPBS signal had no relationship with postoperation permanent DI in statistics. Conclusions The pituitary adenoma size can influence PPBS visible in MRI. Giant adenoma was more commonly nonvisible. And postoperation permanent DI is commonly occurred in PPBS-invisible patients in post operation MRI. The presence of PPBS in the infundibuloneurohypophyseal system indicates its functional maintenance in large adenomas.
出处
《北京医学》
CAS
2008年第10期600-603,共4页
Beijing Medical Journal
关键词
垂体腺瘤
垂体后叶高信号
尿崩症
Pituitary adenoma Posterior pituitary bright spot Diabetes insipidus
