CAJ | 학술논문

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±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(0.0～1.9),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.
목적 통과대수체류MRI영상학특정적연구,결합환자적신경안과학표현,진일보탐토수체류도치환자시공능장애적가능원인.방법 장48례수체류환자분위시교차수압이위화시교차미수압량조,비교량조환자시력하강솔화시야결손솔적차이.이MRI정중시상위화관상위종류적상대고도위자변량,환자쌍안시력하강치위응변량진행직선상관화회귀분석.결과 48례수체류환자중,38례(79%)시교차수압향상이위,시력하강솔화시야결손솔분별위78%화54%,10례(21%)시교차미수종류압박,시력하강솔화시야결손솔분별위60%화30%,량조환자시력하강솔화시야결손솔차이균무통계학의의.MRI정중시상위화관상위종류상대고도평균치분별위2.0±1.2(0.0～5.5)cm화1.7±1.1(0.0～5.0)cm,쌍안시력하강치평균0.9±0.6(0.0～1.9),종류적상대고도여환자쌍안시력하강치정정상관관계.결론 제시교차수종류압박화"절혈"궤제외,시교차공혈동맥수루역가능시수체류환자출현시공능장애적중요원인.
Objective To study magnetic resonance imaging(MRI)radiological characteristics and neuro-ophthalmology to demonstrate the cause of visual disturbance(VD)of pituitary adenomas(PAs) patients.Methods Forty eight patients with PAs were selected.Their medical records and MRI radiological films were reviewed.And the patients were divided into optic ehiasma(OC)invasion group and noninvasion group.The relationship between the tumor and the OC were studied with neuro-ophthalmological findings.The relative heiights of the tumor on the median sagittal and coronal MR images were taken as independent vailables respectively.The vatues of visual loss(VL)in double eyes were selected as dependent variables.Then,the linear correlation and regression were carded out.Results In 48 patients.there were 38 cases(79%)with suprasellar extension of tumom and upward displacement of the OCs.The rates of VL and visual field defects(VFDs)were 78%and 54%,respectively.There were 10 cases (21%)without chiasmal jnvolvement.The rates of the VL and the VFDs were 60%and 30%,respectively.There was no significant difference between the two groups in the rates of VL and the same results could be found about VFDs.The relative height of tumors was 2.0±1.2(range,from 0.0 to 5.5)cm as measured from the median sagittal MR images and 1.7±1.1(range.from 0.0 to 5.0)cm as measured from the coronal MR images.The decrease value of visual acuity in the double eyes was 0.9±0.6 (range,from 0.0 to 1.9).The relative heishts of the tumors,no matter measured from the median sagittal or coronal MR images,were linearly significantly correlated with the visual acuity decrease vatue of the double eyes,Conclusion Besides chiasma invasion and stealing blood.the invasion of chiasmal arteries nlight be a important cause for visual disturbance of pituitary adenomas patients.