目的 分析颅底型垂体瘤的临床 特点及影像学表现。方法 收集我医院 2013年6月-2017年12月期间收治的118例 颅底型垂体瘤患者的临床资料，均接受 MRI检查，并经手术病理证实。收集和分 析入选患者的人口学特征、临床症状、 内分泌检查结果、术后病理结果、垂体 功能减退等资料，并分析患者MRI影像学 表现。结果 颅底型垂体瘤患者以视力下 降、头痛、头晕等为主要症状，以肢端肥 大、腰背关节疼痛、月经不调等为次要症 状；病理类型以泌乳素瘤、生长激素瘤居 多，其次为促性腺激素瘤、促肾上腺皮质 激素瘤、促甲状腺激素瘤、多激素腺瘤； 多数患者为大腺瘤，伴或不伴垂体功能减 退；肿瘤大小与颅底型垂体瘤病理分型密 切相关(P＜0.05)，而与垂体功能减退情 况无明显关系(P＞0.05)。MRI显示颅底型 垂体瘤多呈圆形或类圆形，边缘光滑清 晰，为等密度或高密度肿块，部分患者可 见鞍底破坏肿瘤侵入蝶窦内、因突破鞍隔 生长呈“束腰征”、斑片状钙化、高密度 血肿及坏死或囊变信号；T1WI低等信号， T2WI稍高或高信号动态增强扫描明显不 均匀强化。结论 颅底型垂体瘤在临床症 状、病理类型、影像学表现等方面具有典 型特征，MRI检查可清晰显示肿瘤大小、 形态、出血、钙化及生长情况，对颅底型 垂体瘤的术前诊断有重要作用。

Objective To analyze the clinical and imaging features of skull base-type pituitary adenoma. Methods The clinical data of 118 patients with skull base-typepituitary adenoma who were admitted to the hospital from June 2013 to December 2017were collected. All patients were examined by MRI and confirmed by surgery and pathology. Data such as demographic characteristics, clinical symptoms, results of endocrine examination, postoperative pathological findings and hypopituitarism were collected and analyzed, and MRI findings were analyzed. Results The main symptoms of patients with skull base-type pituitary adenoma were fading eyesight, headache and dizziness. They were secondary symptoms such as acromegaly, back pain and irregular menstruation. Most of the pathological types were prolactinoma and somatotropinoma, followed by gonadotrophin adenoma, adrenocorticotropic hormone adenoma, thyroid stimulating hormone adenomaand multi-hormone adenoma. Most of the patients had large adenomas with or without hypopituitarism. The size of tumors was closely related to the pathological type of pituitary tumors (P<0.05), but not significantly correlated with hypopituitarism (P>0.05).MRI showed the skull base-type pituitary adenomas were round or oval, with clear and smooth edges, which were masses with equal density or high density. There was sellar floor tumor destruction invaded sphenoid sinus, hourglass sign because of breakthrough growth, patchy calcification, high-density hematoma and necrotic or cystic signal. T1WI showed low and equal signal, while T2WI showed slightly high or high signal. Dynamic enhancement scanning showed inhomogeneous enhancement. Conclusion There are typical characteristics of skull base-type pituitary adenomas in terms of clinical symptoms, pathological types and imaging findings. MRI can clearly show the size, shape, hemorrhage, calcification and growth of tumors, which is important for preoperative diagnosis of skull base-type pituitary adenoma.