空蝶鞍综合征的核磁共振成像诊断20例报告论文_关荣

黑龙江省加格达奇大兴安岭地区第二人民医院 165000

摘要:目的:探讨空蝶鞍综合征的核磁共振成像诊断应用价值。方法::随机的选择2017年2月到2018年2月来我院就诊的空蝶鞍综合征患者20例,对他们的病情进行回顾性分析。在这20名患者入院的时候均对他们进行同样的治疗手段。20例患者全部行核磁共振平扫,特殊患者进行增强扫描,常规进行矢状位冠状位、轴位扫描。扫描过后通过成像测量20例患者垂体上下径、前后径、左右径、垂体柄高径、直径、垂体柄与水平线成角并对各径线进行比较,结合CT及临床表现对患者的病情进行综合分析。结果:空蝶鞍综合征核磁共振成像表现为蝶鞍扩大、垂体变薄及“锚”征等,女性发病率明显高于男性。而且鞍综合征患者与正常人垂体左右径、垂体前后径、垂体上下径、垂体柄高径、直径及垂体柄与水平线成角之间均有显著性差异(P<0.05)。结论:通过核磁共振成像诊断可以很清楚地对空蝶鞍综合征患者的一些病症进行显示,能够为空蝶鞍综合征的诊断提供有效的依据,值得在实际当中被广泛的推广使用。

关键词:空蝶鞍综合征;核磁共振成像诊断;应用价值

Magnetic resonance imaging diagnosis of empty sella syndrome: report of 20 cases

Abstract: Objective: To investigate the diagnostic value of Magnetic resonance imaging in the diagnosis of empty sella syndrome. METHODS: Twenty patients with empty sella syndrome who came to our hospital from February 2017 to February 2018 were randomly selected for retrospective analysis of their condition. The 20 patients were treated with the same treatment when they were admitted to the hospital. All 20 patients underwent Nuclear magnetic resonance plain-scan, special patients underwent enhanced scans, and routine sagittal coronal and axial scans were performed. After scanning, 20 cases of pituitary diameter, anteroposterior diameter, left and right diameter, pituitary stalk height diameter, diameter, pituitary stalk and horizontal line were angled and compared with each other. The CT and clinical manifestations were combined to analyze the patient's condition. analysis. RESULTS: The Magnetic resonance imaging of the empty sella syndrome showed an enlargement of the sella, a thinning of the pituitary and an "anchor" sign. The incidence of women was significantly higher than that of men. There was also a significant difference between the left and right pituitary diameters, the anteroposterior diameter of the pituitary, the anteroposterior diameter of the pituitary, the height of the pituitary stalk, the diameter, and the angle between the pituitary stalk and the horizontal line in the patients with saddle syndrome (P<0.05). Conclusion: Magnetic resonance imaging diagnosis can clearly show some of the symptoms of patients with empty sella syndrome, which can provide an effective basis for the diagnosis of empty sella syndrome, and it is worthy of widespread use in practice.

Key words: empty sella syndrome; magnetic resonance imaging diagnosis; application value

引言:空蝶鞍综合征在MRI问世之前,多认为此病少见,未能受到足够重视[1]。本症是指蛛网膜下腔疝入到蝶鞍内,垂体被压平而位于鞍底产生一系列的症候群如头痛、高血压、肥胖、CSF鼻漏、视力障碍、神经及内分泌异常等症状[2]。因其临床症状不典型,极易被误诊和漏诊。因为核磁共振成像诊断技术的诞生,空蝶鞍综合征的诊断日益明确并已成为主要检查手段。本文收集有完整资料的空蝶鞍综合征20例,就其发病机制、临床表现及MRI征象进行总结,以增加对其认识。

资料与方法

1.1一般资料

随机的选择2017年2月到2018年2月来我院就诊的空蝶鞍综合征患者20例。选取的20名患者当中男3例,女17例。年龄分布为31-76岁之间,平均年龄在(44.2±3.18)岁。临床表现有:头痛、头晕10例;视力下降、视野缺损3例;月经不调或闭经4例;泌乳3例。

1.2方法

本次检查均采用日本岛津公司生产SMT-100X机器进行扫描,场强1.0T,采用头颅表面线圈。在开始核磁共振成像诊断之前,全部病例均进行血常规,血电解质,血气分析,肝肾功能,T3、T4,TSH,血皮质醇,及染色体等检查,保证所有患者的指标均正常。随后20例患者全部行核磁共振平扫,特殊患者进行增强扫描,常规进行矢状位冠状位、轴位扫描。扫描过后通过成像测量20例患者垂体上下径、前后径、左右径、垂体柄高径、直径、垂体柄与水平线成角并对各径线进行比较,结合CT及临床表现对患者的病情进行综合分析。

2.结果

3.讨论

空蝶鞍综合征1951年由Busch提出,随着影像学的发展,对本病的认识日趋深入[3]。蝶鞍综合征分两大类:一类无明显病因可寻者,称“原发性空泡探鞍综合征、一类由鞍内或鞍旁手术或放疗引起者,称“继发性空泡蝶鞍综合征”。空泡蝶鞍综合征的发生,大多与鞍隔缺损有关。空蝶鞍综合征应引起临床医师高度重视,凡有顽固性头疼、头晕、视力障碍、内分泌紊乱等一系列症状者应考虑本病。从上述试验的结果来看,通过核磁共振成像诊断可以很清楚地对空蝶鞍综合征患者的一些病症进行显示,能够为空蝶鞍综合征的诊断提供有效的依据,值得在实际当中被广泛的推广使用。

参考文献:

[1]李彩萍.空蝶鞍综合征的病因与诊断[J].国外医学·内分泌学分册,1996,16(01):1133-1134.

[2]郑足珍,姚国英. 磁共振扫描对空蝶鞍症的诊断价值(附5例报告)[J].中原医刊,1998,25(07):412-415.

[3]胡蜀红,张木勋.35例空蝶鞍综合征的临床分析[J].华中科技大学学报(医学版),2003,23(03):306-309.

论文作者:关荣

论文发表刊物:《中国结合医学》2019年第01期

论文发表时间:2019/4/8

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空蝶鞍综合征的核磁共振成像诊断20例报告论文_关荣
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