Elderly women, blurred vision for more than 1 year, aggravated with headache in February, please diagnose!

Neurosurgery"Basic Information"patients, female, 60 years old"main complaint"vision blurred for more than 1 year, aggravated with headache February"current medical history"patients a year ago without obvious causes of visual blur, accompanied by poor spirit, external hospital head tips CT saddle area accounted for, in special treatment, before February patients with symptoms(Image)diagnosis?discussionComment: Butterfly saddle expansion, saddle under the fall, saddle area see clumps such as T1, slightly longer T2 signal, its internal signal is not uniform, see the patchy long T1 signal, like visible vascular air shadowDepending on the cross pressure upNormal pituitary disappearsThe two-sided sponge sinuses are tiredThe enhanced scan is significantly less uniformResults What you see in the operation: the lesions are located in the butterfly saddle, the texture is more strong and uneven, gray-red, medium blood transport Pathological Diagnosis: (pituitary tumor) consider pituitary tumor, please combine clinical analysis Case Summary This example is mainly based on realness, the tumor is mainly T1, slightly longer T2 signal, invade and saddle, under the saddle, can be seen "beam waist sign" (blue arrow) The two-sided sponge sinuses are tired (red arrow) Pituitary adenomas can be divided into microadenomas (1.0cm in diameter), large adenomas (diameters of 1.0cm) and large adenomas (diameters of 3.0cm) MRI is characterized by the disappearance of normal pituitary structure, saddle area or / and saddle occupied, a long T1, long T2 signal, tumor signal more uniform, can be due to necrosis, cystic signal uneven, calcified rare Enhanced scanning tumors are uniform or ring-shaped moderate reinforcement The tumor grows upward to break through the saddle, which is called a dumbbell-like in the crown bit, and the MRI examination can show the double-sided sponge sinuses and the visual cross pressure CT shows the in-saddle and saddle pool round or class round such density (63%) or slightly higher density (26%) lumps, the boundary is clear, the boundary of the invasive pituitary tumor is not clear identification diagnosis pituitary microadenoma MR as a pituitary limit abnormal signal, T1WI is slightly lower than normal pituitary signal, T2WI demarcation is not obvious; Rathke fissac the main symptoms are headache, some patients are accidentally found, the lesions can be confined to the saddle, can also be protruding saddle, butterfly saddle usually no expansion, visible pressure dpititon, lesions and pituitary boundary clear; T1WI is often a high signal or low signal, T2WI signal changeable; cranial pharynx tumor is mainly located in the saddle, half can be extended into the saddle, cystic and calcification is its characteristics, so CT is high, medium and low mixed density MR is mostly mixed signals, where about 50% of the cysty part in TIWl is a high signal, coronary, coronary scans visible tumors are not connected to the pituitary body Saddle area meningioma CT flat sweep for the same density or slightly higher density, common sand-grain calcification in the tumor, after strengthening there is significant reinforcement MR is mostly such as TI T2 signal, the tumor can have a curved strip-shaped empty signal Enhanced scans are also significantly uniformly enhanced The pituitary size signal is OK germ cell tumor male good hair, most patients in the middle line, the good hair site for the hypothalamus, pine algo region and base section area (5% to 10%) ; CT performance is slightly high density lump; MRI typical performance is such as T1 T2 signal, signal uniform, enhanced scanning lesions are significantly strengthened, lesions can also appear in the cystic, but bleeding, bad disease; source: the image
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