蝶鞍窝扩大的鉴别诊断,郑大一附院 李树新,蝶鞍 反映颅内情况的一面“镜子”,蝶鞍 悬在中颅窝内的骨性结构 垂体的容器,蝶鞍的正常影像学表现,正常蝶鞍X线解剖,薄背 部分气化蝶窦,厚背 完全气化蝶窦,韧带钙化 几未气化蝶窦,蝶鞍扩大的X线解剖,鞍背后倒与斜坡成角 双鞍背 双鞍底 一侧前床突翘起 两侧前床突呈“剪刀”状分离 鞍窝呈气球样扩张,蝶鞍扩大的鉴别诊断,垂体瘤（嫌色 GH 混合） 颅咽管瘤（鞍内 鞍内/鞍上型） 空泡蝶鞍 海绵窦占位（动脉瘤 神经鞘瘤 脑膜瘤） 颅内压增高,垂 体 瘤,51 Y/O F. chromophobe,51 Y/O F. chromophobe,51 Y/O F. chromophobe,51 Y/O F. chromophobe,30Y/O M. GH giantism200cm tall at 15Y/O,45Y/O. M. GH acromegaly,45Y/O. M. GH acromegaly,42Y/O. F. GH acromegaly,two cases of acromegaly,颅咽管瘤,23Y/O. F craniopharyngioma,45Y/O. M. cystic craniopharyngiomaegg-shell calcification,45Y/O. M. cystic craniopharyngiomaegg-shell calcification,A case of cal pituitary adenoma,64Y/O. M.craniopharyngioma,64Y/O. M.craniopharyngioma,颅咽管瘤的来源及好发部位,50Y/O. M. supersella craiopharyngioma,17Y/O. F Infrasella craiopharyngioma,空泡蝶鞍,ES Pneumoencephalogram,ES CT,36Y/O. F smaller ES,36Y/O. F smaller ES,36Y/O. F smaller ES,41Y/O.M. Larger ES,41Y/O.M. Larger ESthe “anchor” sign,60Y/O. M. huge ES,60Y/O. M. huge ES,56Y/O. M. huge ESCTM proved,海绵窦占位病变,Parasella aneurysm,Sella enlargement,Left superorbital fissure and optic nerve foramen enlargement,Left parasella mass,left parasella mass,left parasella aneurysm,45Y/O.M. left parasella schwannoma,45Y/O.M. left parasella schwannoma,颅内压增高,22Y/O.F. tuberculosis meningitis I I P CSF pressure 400mm water sella AP=21mm,谢谢！,