目的:Rathke裂囊肿是常见的鞍区病变,它们的炎症会引起症状和复发。囊肿壁增强与炎症有关;然而,其范围和频率尚未调查。本研究旨在探讨炎症性和非炎症性Rathke裂囊肿的临床和放射学差异。
方法:对2008年1月至2022年7月行Rathke裂囊肿减压术的41例患者进行回顾性分析。根据病理报告,患者分为炎症组和非炎症组.临床评估,内分泌评估,囊肿含量分析,和成像指标(平均计算机断层扫描值,最大直径,平均表观扩散系数[ADC]值,和定性特征)进行了分析。进行了接收器工作特性曲线分析,为了确定ADC截止值,用于区分炎症组和非炎症组。
结果:完全,21和20例分为炎症和非炎症组,分别。炎症组表现出更高的发病率中心性尿崩症(精氨酸加压素缺乏)(p=0.04),浑浊囊肿含量(p=0.03),显着降低平均ADC值(p=0.04),磁共振成像(MRI)上更广泛的圆周壁增强(p<0.001)。在炎症组中,所有病例都显示圆周壁增强,有些表现出厚壁增强。其他放射学特征没有显着差异。区分两组的ADC截止值为1.57×10-3mm2/s,敏感性为81.3%,特异性为66.7%。放射学上,他们在MRI上表现出较低的平均ADC值和较大的圆周壁增强。
OBJECTIVE: Rathke cleft cysts are commonly encountered sellar lesions, and their inflammation induces symptoms and recurrence. Cyst wall enhancement is related to inflammation; however, its range and frequency have not yet been investigated. This study aimed to investigate the clinical and radiological differences between inflammatory and non-inflammatory Rathke cleft cysts.
METHODS: Forty-one patients who underwent cyst decompression surgery for Rathke\'s cleft cysts between January 2008 and July 2022 were retrospectively analyzed. Based on the pathological reports, patients were divided into inflammatory and non-inflammatory groups. Clinical assessments, endocrinological evaluations, cyst content analysis, and imaging metrics (mean computed tomographic value, maximum diameter, mean apparent diffusion coefficient [ADC] value, and qualitative features) were analyzed. Receiver operating characteristic curve analysis was performed, to determine ADC cutoff values, for differentiating inflammatory group from non-inflammatory group.
RESULTS: Totally, 21 and 20 cases were categorized into the inflammatory and non-inflammatory groups, respectively. The inflammatory group displayed a higher incidence of central diabetes insipidus (arginine vasopressin deficiency) (p = 0.04), turbid cyst content (p = 0.03), significantly lower mean ADC values (p = 0.04), and more extensive circumferential wall enhancement on magnetic resonance imaging (MRI) (p < 0.001). In the inflammatory group, all cases revealed circumferential wall enhancement, with some exhibiting thick wall enhancement. There were no significant differences in other radiological features. The ADC cutoff value for differentiating the two groups was 1.57 × 10-3 mm2/s, showing a sensitivity of 81.3% and specificity of 66.7% CONCLUSION: Inflammatory Rathke cleft cysts tended to show a higher incidence of central diabetes insipidus and turbid cyst content. Radiologically, they exhibited lower mean ADC values and greater circumferential wall enhancement on MRI.