垂体脓肿的诊断与治疗(附10例报告)

目的探讨垂体脓肿的临床特点、诊断和治疗。方法回顾性分析10例垂体脓肿的病史、临床表现、影像学表现、手术记录和随访结果。结果8例早期出现尿崩症,影像学表现为MRI检查T1像等信号或低信号,T2像等信号或高信号,环行强化,5例垂体柄增粗50%,随访6个月至4年,均未见复发。结论早期尿崩症、垂体柄增粗和环形强化的囊性病灶应首先怀疑垂体脓肿,早期诊断、及时手术和合理的抗生素治疗是提高垂体脓肿预后的关键。

Diagnosis and treatment of pituitary abscess:a review of 10 cases

Objective To explore the clinilal features,diagnosis and treatment of pituitary abscess.Methods 10 cases of pituitary abscess were reviewed,including history,clinical presents,iconography,operative documents and follow-up.Results Eight of patients were manifested with diabetes insipidus,the majority of pituitary abscesses demonstrated iso- or hypointense on T1-weighted MR images,iso-or hyperintense signal on T2-weighted MR images and rim enhancement after the intravenous administration of gadolinium-based contrast material.Five cases demonstrated wideness of pituitary stalk.Postoperative courses were uneventful with no recurrence.Conclusion It were suggestive of pituitary abscess when any patients presented with earlier diabetes insipidus,rim enhancement and widement of pituitary stalk.Earlier diagnosis and timely surgery with the use of antibiotic are the key treatment of pituitary abscess.