イチハラ　アツヒロ   ICHIHARA Atsuhiro   市原　淳弘    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Clinical and radiological features of Rathke's cleft cysts with inflammatory change: Multivariable analysis of 262 surgically treated cases.
掲載誌名	正式名：Clinical neurology and neurosurgery 略　 称：Clin Neurol Neurosurg ISSNコード：18726968/03038467
掲載区分	国内
巻・号・頁	262,pp.109306
著者・共著者	Kosaku Amano, Kenta Masui, Yuichi Oda, Takashi Komori, Shihori Kimura, Kaoru Yamashita, Noriyoshi Takano, Yasufumi Seki, Daisuke Watanabe, Michio Otsuki, Atsuhiro Ichihara, Takakazu Kawamata
発行年月	2026/03
概要	OBJECTIVE:To characterize clinical and MRI features of Rathke's cleft cysts (RCCs) with inflammatory change and assess their associations with endocrine and surgical outcomes.METHODS:We retrospectively reviewed 262 surgically treated RCCs at a single institution (1998-2023). All patients underwent preoperative MRI and endocrine testing. Postoperative pathology classified cases as with inflammatory change (Group A, n = 56) or without (Group B, n = 206). Group comparisons used standard statistics; key MRI signs were circumferential rim enhancement and mixed T2 signal.RESULTS:Compared with Group B, Group A had more impaired pituitary axes (mean 3.9 vs. 1.1; p < 0.001) and higher rates of diabetes insipidus (33.9 % vs. 1.5 %; p < 0.0001) and visual field defects (62.5 % vs. 31.6 %; p < 0.0001). Circumferential rim enhancement (71.4 % vs. 6.3 %; p < 0.0001) and mixed T2 signal (66.1 % vs. 6.8 %; p < 0.0001) were strongly associated with inflammatory change. Postoperative endocrine recovery was less frequent in Group A (21.7 % vs. 64.6 %; p < 0.0001), and reoperation for recurrence was more common (14.3 % vs. 2.4 %; p = 0.001). Two illustrative cases demonstrated concordance between inflammation severity, MRI features, and outcomes.CONCLUSION:RCCs with inflammatory change are associated with severe preoperative pituitary dysfunction, poorer endocrine recovery, and higher recurrence. Simple MRI signs-especially circumferential rim enhancement and mixed T2 signal-may help identify inflammatory cases preoperatively and support consideration of earlier surgical intervention to preserve pituitary function.
DOI	10.1016/j.clineuro.2025.109306
PMID	41506125