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MR Imaging Diagnosis of Pituitary ACTH Microadenoma <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
金征宇 李明利 冯逢 陆菁菁 有慧 李小圳
Jin zhengyu,Li mingli, Feng Feng,,Lu jingjing,You Hui, Li Xiaozhen
Department of Radiology, PUMC Hospital,CAMS and PUMC,beijing 100730,china
Absract
Purpose：To study the MRI feature and diagnosis of pituitary ACTH microadenoma .
Methods：MR imagings of 18 cases of ACTH microadenoma confirmed by operation and pathology were analysed retrospectively.All of the cases underwent dynamic MR,conventional enhanced MR and unenhanced MR. The MR imaging findings were compared to surgical and histopathological findings.
Results：24 ACTH microadenoma were identified by operation and histopathology,6 patients have 2 adenoma in pituitary, 12 patients have single. The average size was 5.7mm(2-10mm), the majority of adenoma were round or ellipse ,only 2 were irregular.11 pituitary shapes changed for present of adenoma. Low signal can be seen on convention unenhance MR imaging(9 adnoma),conventional enhance MR imaging(14 adenoma) and dynamic MR imaging(24 adenoma and 3 faslve low signal ) . 4 patients can only be diagnosed on dynamic MRI imaging.
Conclusion：The major MRI character of ACTH microadenoma was low signal in pirutary, dynamic MR were sensitive to the signal change and improved the tumor dectection rates.
Key words：Pituitary neoplasms; microadenoma; Magnetic resonance imaging
MRI为目前检查垂体病变的最佳手段，近年来随着高场强磁共振及动态扫描技术的应用，垂体微腺瘤的检出率不断提高。有关的研究样本中多同时包含了各种类型的微腺瘤，且以泌乳素瘤为多，而针对ACTH微腺瘤较大样本的研究报道尚不多[1]。本研究回顾性分析了一组经手术病理确诊的ACTH微腺瘤的MRI资料，对ACTH微腺瘤的MRI表现进行总结，并对MRI诊断的相关问题进行探讨。
材料和方法
资料来源及入组标准：MRI资料来源于我院MRI室2000年－2003年所作的垂体检查，只分析有动态增强检查的资料，共200例。入组标准：住院病人，临床确诊为库欣氏综合症，经蝶窦行垂体探察和肿瘤切除术，病理证实为ACTH腺瘤。排除标准：MRI资料不全，没有手术或活检，病理组织学（包括免疫组化）检查不能证实为ACTH腺瘤，腺瘤的最大径大于10mm。最终符合条件的共18例。其中男4例，女14例。平均年龄31岁（13－62岁）。 | 
