Diagnosis,Treatment And Differential Diagnosis Of 41 Cases Of Cystic Lesions Insaddle Region

Objective:To analyze and contrast the clinical features,Imaging features and intraoperative cystic fluid performance of four kinds of cystic lesions in sellar region such as craniopharyngioma,Rathke cleft cyst,pituitary abscessand pituitary apoplexy.and to construct a flowchart for difierenfial diagnosis of the four difierent kinds of cystic lesions.Methods:Clinical data of 41 cases patient of cystic lesions in sellar region:16 cases of Rathke'S cleft cyst,10 cases of craniopharyngioma,3 cases of Pituitary abscess and 12 cases of pituitary apoplexy were diagnosed by Imaging,surgery and pathology from October 2015 to December 2017 in the Department of Neurosurgery of Drum Tower Hospital Affiliated to Medical School of Nanjing University were retrospectively analyzed.and to compare the clinical characteristics of different patients and corresponding imaging differences.Results:The clinical manifestations of all patients were headache,vision and visual field obstruction and pituitary dysfunction.The imaging features of Rathke cyst were more frequently to be seen with cystic characteristics,often without calcification and with no or thin layer reinforcement;Craniopharyngioma peform mixed solid and cystic characterisitics,with uniform circular reinforcement,The age of onset is lower than other cystic lesions,lesion volume performance is larger and part of the third ventricle wasoppressed and infringement of cavernous sinus;The disease course of Pituitary abscess is relatively short,and the imaging findings are pure cystic,and the peripheral annular enhancement and the appearance of meningeal cauda are often present,this cases often appearsuch some performance such as urine collapse and low pituitary hormone Pituitary apoplexy can appear headache,vision loss,visual field defect,etc.in short time the imaging findings are pure cystic with thickening of the cystic wall and there often shows fluid level in the cystic.In the short period of pituitary apoplexy,headache,vision loss,visual field defect and other manifestations can be found.The imaging findings are simple cystic,thickening of the cyst wall,and fluid level in the capsule.Conclusion:Although the preoperative differential diagnosis was difficult for the cystic lesion of saddle region disease,the clinical characteristics and radiographic features may overlapping each other,But it can be identified according to the imaging and clinical symptoms.Microsurgical technique via transsphenoidal approach is a safe and effective one for the treatment of patients with non—adenomas disease intrasellar region.