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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51Y/OF.chromophobe51Y/OF.chromophobe51Y/OF.chromophobe51Y/OF.chromophobe30Y/OM.GHgiantism200cmtallat15Y/O45Y/O.M.GHacromegaly45Y/O.M.GHacromegaly42Y/O.F.GHacromegalytwocasesofacromegaly颅咽管瘤23Y/O.Fcraniopharyngioma45Y/O.M.cysticcraniopharyngiomaegg-shellcalcification45Y/O.M.cysticcraniopharyngiomaegg-shellcalcificationAcaseofcalpituitaryadenoma64Y/O.M.craniopharyngioma64Y/O.M.craniopharyngioma颅咽管瘤的来源及好发部位50Y/O.M.supersellacraiopharyngioma17Y/O.FInfrasellacraiopharyngioma空泡蝶鞍ESPneumoencephalogramESCT36Y/O.FsmallerES36Y/O.FsmallerES36Y/O.FsmallerES41Y/O.M.LargerES41Y/O.M.LargerESthe“anchor”sign60Y/O.M.hugeES60Y/O.M.hugeES56Y/O.M.hugeESCTMproved海绵窦占位病变ParasellaaneurysmSellaenlargementLeftsuperorbitalfissureandopticnerveforamenenlargementLeftparasellamassleftparasellamassleftparasellaaneurysm45Y/O.M.leftparasellaschwannoma45Y/O.M.leftparasellaschwannoma颅内压增高22Y/O.F.tuberculosismeningitisIIPCSFpressure400mmwatersellaAP=21mm