【摘要】 目的研究垂体腺瘤的影像特征对诊断其侵袭性的价值。方法分析103例垂体腺瘤的影像特征。以外科手术中所见为标准,分别计算各组MRI特征的敏感性(SEN)、特异性(SPE)、阳性似然比(+LR)、阴性似然比(-LR)。结果(1)出现下列征象之一者则侵袭性垂体腺瘤的诊断比较明确:肿瘤长入蝶窦腔内(+LR为∝),肿瘤包绕颈内动脉的程度≥6/8(+LR为∝),冠状片上肿瘤未超过颈内动脉海绵窦窦内、窦上段的外切线(+LR为∝);(2)排除侵袭存在的征象为:侵袭鞍底骨、鞍底形态完整(-LR为0·10),肿瘤包绕颈内动脉的程度<2/8(-LR为0),冠状片上肿瘤超过颈内动脉海绵窦窦内、窦上段的内切线(-LR为0);(3)高度怀疑侵袭存在的征象为:肿瘤跨越中分线(+LR为14·89),肿瘤包绕颈内动脉的程度在3/8和5/8之间(+LR分别为24·81、64·28、98·11)。结论上述影像征象有助于判诊断垂体腺瘤的侵袭性。更多还原

【Abstract】 Objective To find the imaging signs for diagnosing the invasive pituitary adenoma(IPA).Methods The radiological images obtained from 103 patients with IPA were reviewed retrospectively. The ‘golden’ standard diagnosing IPA was the surgical findings.The sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (-LR) of imaging signs in each group were calculated. Results (1)The imaging signs for diagnosing IPA included the tumor infiltrating into the sphenoid sinus (+LR为∝),the percentage encasing the internal carotid artery (ICA) of tumor being ≥6/8(+LR为∝),the line joining the lateral wall of the intracavernous and supracavernous ICA being passed by the tumor (+LR ∝). (2)The imaging signs for excluding IPA were the sellar floor bone not being eroded and the morphosis of the sellar floor being integral (-LR 0.10),the percentage encasing the internal carotid artery (ICA) of tumor being <2/8 (-LR 0),the line joining the medial wall of the intracavernous and supracavernous ICA not being passed by the tumor (-LR 0). (3)The imaging signs for probably diagnosing IPA were the line joining the center of the intracavernous and supracavernous ICA being passed by the tumor(+LR 14.89), the percentage encasing the internal carotid artery (ICA) of tumor being >3/8 and <5/8(+LR 24.81,98.11, respectively). Conclusion The above-mentioned criteria may be of assistance to diagnoze IPA.更多还原