Jie Ren1*, Diansheng Chen2
1.China University of Mining&Technology (Beijing); 2.Anhui Provincial Hospital Affiliated to Anhui Medical
University
Abstract：
Objective To explore the diagnostic potential of Magnetic Resonance Imaging (MRI) features, identify
characteristic MRI signs, and establish a diagnostic flowchart model to distinguish between cystic pituitary
adenomas and Rathke ’ s cleft cysts. Method A retrospective analysis was conducted on the MRI data of 73
patients with sellar cystic lesions confirmed by surgical pathology at Anhui Provincial Hospital from January 2017
to June 2024, including 36 patients with cystic pituitary tumors and 37 patients with Rathke’s cleft cysts. The
following imaging features were assessed: fluid-fluid level, hypointensity border on T2-weighted imaging (T2WI), septation sign, intracystic nodule, lesion shape, maximum lesion diameter, lesion location, lesion symmetry, and
signal homogeneity. Chi-square tests were applied to screen for significant imaging signs. Subsequently, characteristic imaging signs were selected based on logistic regression analysis results, and a differential
diagnostic flowchart was constructed. Result Specific MRI signs for cystic pituitary adenomas included: off- midline location, lesion asymmetry, fluid-fluid level, septation sign, and hypointensity rim on T2WI. Specific MRI
signs for Rathke cleft cysts included: midline location and lesion symmetry. A differential diagnostic flowchart
was developed based on these MRI features. Conclusion This differential diagnostic flowchart aids in
distinguishing cystic pituitary adenomas from Rathke cleft cysts.
Key Words：
Rathke's cyst; differential diagnosis; cystic pituitary adenoma; magnetic resonance imaging features
