CAJ | 학술논문

目的探讨鼻咽癌放疗后垂体功能减退(RIH)的临床特点及影像学表现. 方法回顾性分析自2000年至2010年在中山大学孙逸仙纪念医院就诊的鼻咽癌放疗后诊断为RIH的9例患者临床资料(男7例,女2例),分析其临床表现、激素水平、影像学表现及后期随访结果. 结果 9例患者均诊断为RIH,距离放疗结束的时间为10月～15年.5例患者发现1种以上垂体分泌激素的紊乱,其中甲状腺激素分泌减少和高催乳素血症是最常见的表现,其次是促肾上腺皮质激素分泌减少.2例患者影像学表现为垂体萎缩和空泡蝶鞍.5例患者经激素替代治疗后症状改善.结论鼻咽癌放射治疗可导致垂体功能损害,大部分患者表现为亚临床症状并缺乏典型垂体改变,早期、定期的激素监测和影像学随访对于RIH的早期诊断和治疗尤为重要.
목적 탐토비인암방료후수체공능감퇴(RIH)적림상특점급영상학표현. 방법 회고성분석자2000년지2010년재중산대학손일선기념의원취진적비인암방료후진단위RIH적9례환자림상자료(남7례,녀2례),분석기림상표현、격소수평、영상학표현급후기수방결과. 결과 9례환자균진단위RIH,거리방료결속적시간위10월～15년.5례환자발현1충이상수체분비격소적문란,기중갑상선격소분비감소화고최유소혈증시최상견적표현,기차시촉신상선피질격소분비감소.2례환자영상학표현위수체위축화공포접안.5례환자경격소체대치료후증상개선.결론 비인암방사치료가도치수체공능손해,대부분환자표현위아림상증상병결핍전형수체개변,조기、정기적격소감측화영상학수방대우RIH적조기진단화치료우위중요.
Objective To investigate the clinical characteristics and imaging features of radiation-induced hypopituitarism (RIH) in nasopharyngeal carcinoma (NPC) patients after radiotherapy.Methods Retrospective study was performed on the clinical data of 9 NPC patients (7 males and 2 females), diagnosed as RIH after radiotherapy in our hospital from 2000 to 2009; their clinical manifestations, anterior-pituitary hormone levels, cranial MRI features and follow-up results were analyzed. Results The interval between complications after radiotherapy and diagnoses of RIH varied from 10 months to 15 years.Multiple hormone deficits appeared in 5 patients; thyrotropin deficiency and hyperprolactinemia were the most common complications, followed by adrenocorticotropic hormone (ACTH) insufficiency.Typical radiological imaging of the pituitary gland displayed partially empty sella and atrophy of pituitaly gland,which was demonstrated in 2 patients.Five patients got improvement after hormone replacement therapy. Conclusion Radiation-induced hypopituitarism may occur in NPC patients; most patients are subclinical without typical radiological alterations in MRI for pituitary.Routine evaluation of adenohypophysis function is necessary for early detection of hormone deficiency and early hormone replacement treatment.