·734·生堡挫丝处赴苤查!Q螋生!旦筮堑鲞筮!翅垦丛!』奠!!塑!强：叁!罂型!Q塑：!丛堑：塑!：!垂体瘤MRI影像学特征与视功能障碍祖朝辉王颖阚志生张宇新【摘要】目的通过对垂体瘤MRI影像学特征的研究，结合患者的神经眼科学表现，进一步探讨垂体瘤导致患者视功能障碍的可能原因。方法将48例垂体瘤患者分为视交叉受压移位和视交叉未受压两组，比较两组患者视力下降率和视野缺损率的差异。以MRI正中矢状位和冠状位肿瘤的相对高度为自变量，患者双眼视力下降值为应变量进行直线相关和回归分析。结果48例垂体瘤患者中，38例(79％)视交叉受压向上移位，视力下降率和视野缺损率分别为78％和54％，10例(21％)视交叉未受肿瘤压迫，视力下降率和视野缺损率分别为60％和30％，两组患者视力下降率和视野缺损率差异均无统计学意义。MRI正中矢状位和冠状位肿瘤相对高度平均值分别为2．0．4-1．2(0．0—5．5)cm和1．7±1．1(0．0—5．0)cm，双眼视力下降值平均0．9±0．6(0．0一1．9)，肿瘤的相对高度与患者双眼视力下降值呈正相关关系。结论除视交叉受肿瘤压迫和“窃血”机制外，视交叉供血动脉受累亦可能是垂体瘤患者出现视功能障碍的重要原因。【关键词l垂体瘤；磁共振成像；视力下降；视野缺损Pituitaryadenomas：MRIradiologicalcharacteristicsandvisualdisturbanceZUZhao．hui’。耽ⅣGH昭，KAN孔i-sheng，ZHANGYu—xin．’DepartmentofNeurosurgery，KailuanHospital，NorthChinaCoalMedicalCollege．Tangshan0卯00lD．China【Abstract】ObjectiveTostudymagneticresonanceimaging(MRI)radiologicalcharacteristicsandneuro—ophthalmologytodemonstratethecauseofvisualdisturbance(VD)ofpituitaryadenomas(PAs)patients．MethodsFortyeightpatientswithPAswereselected．TheirmedicalrecordsandMRIradiologicalfilmswerereviewed．Andthepatientsweredividedintoopticehiasma(0C)invasiongroupandnon—invasiongroup．TherelationshipbetweenthetumorandtheOCwerestudiedwithneuro—ophthalmologicalfindings．Therelativehei【ght8ofthetumoronthemediansagittalandcorolla[MRimagesweretakenasindependentvailablesrespectively．Thevalue$ofvisualloss(VL)indoubleeyeswereselectedasdependentvariables．Then，thelinearcorrelationandregressionwerecardedouLResulIsIn48patients．therewere38c88es(79％)withsuprasellarextensionoftumomandupwarddisplacementoftheOCs．TheratesofVLandviSUalfielddefects(VFDs)were78％and54％，respectively．Therewere10cases(21％)withoutchiasmaljnvolvement．TheratesoftheVLandtheVFDswere60％and30％．respectively．Therewas,nosignificantdifferencebetweenthetwogroupsintheratesofVLandthesanleresulIscouldbefoundaboutVFDs．Therelativeheightoftumo瑁was2．0±1．2(range，from0．0to5．5)cm粕me髓uredfromthemediansa6ttalMRimagesand1．74-1．1(range。from0．0to5．0)cmasmeasuredfrom山ecoronalMRim醒es．ThedecreasevalueofvisualacuityinthedoubleeyesWas0．9±0．6(range，from0．0to1．9)．Therelativeheishtsofthetumo隋，nomattermeasuredfromthemediansagittalorcoronalMRimages．wereIinearlysignificantlycorrelatedwiththevisualacuitydecreasevalueofthedoubleeyes，ConclusionBesidesehiasmainvasionandstealingblood．theinvasionofchiasmalarteriesnlightbeaimportantcauseforvisualdisturbanceofpituitaryadenomaspatients．【Keywords】Pituitaryadenomas；Mfu；Visualloss；Visualfielddefecm垂体瘤是起源于腺垂体上皮细胞的良性肿瘤，占颅内肿瘤的10％一15％，垂体瘤患者常有视力下降、视野缺损的临床表现【卜21。而通过垂体瘤的DOI：10．3760／cma．j．isma．1001-2346．2009．08．025作者单位：063000唐山，华北煤炭医学院附属开滦医院神经外科(祖朝辉、阚志生)；首都医科大学北京神经科学研究所(王颖)；华北煤炭医学院解剖学教研室(张宇新)．临床论著．MRI影像学特征一肿瘤与视交叉的关系、肿瘤向鞍上扩...
