论文部分内容阅读
目的探讨术前影像学测量和重建在经鼻蝶垂体瘤切除术中的应用价值。方法选取22例拟行经鼻蝶手术的垂体大腺瘤患者,术前利用影像归档和通信系统(Picture Archiving and Communication Systems,PACS)对MRI影像进行测量(鼻小柱至蝶窦前壁突出处的距离、颈内动脉海绵窦段间距)和CT蝶鞍区骨质三维重建(蝶窦形态、分隔分布的可视化),指导定位蝶窦、鞍底和肿瘤切除。结果 22例患者,鼻小柱至蝶窦前壁突出处的距离66.62±0.61mm,颈内动脉海绵窦段间距20.67±0.54mm,均顺利定位蝶窦前壁;窦内分隔及鞍底形态与重建影像吻合,鞍底打开充分、肿瘤切除满意,无重要血管损伤病例。结论术前应用CT鞍区三维重建及MRI相关数据测量,指导经鼻蝶垂体瘤切除术,有助于蝶窦前壁和鞍底定位,有助于充分切除肿瘤和保护颈内动脉,具有较高的临床应用价值。
Objective To investigate the value of preoperative imaging measurement and reconstruction in the resection of nasal pituitary tumors. Methods Twenty-two patients with pituitary adenoma who underwent transnasal surgery were enrolled. MRI images were measured preoperatively using the Picture Archiving and Communication Systems (PACS) Distance between the carotid artery cavernous sinus segments), and three-dimensional reconstruction of the sellar bone in the CT sella (visualization of sphenoid sinus morphology and segmental distribution) to guide the location of sphenoid sinus, sella and tumor resection. Results The distance between the columella and sphenoid anterior wall was 66.62 ± 0.61mm and the distance between internal carotid artery and cavernous sinus was 20.67 ± 0.54mm in 22 patients. Image reconstruction reconstruction, saddle open fully, tumor resection satisfaction, no important vascular injury cases. Conclusions The three-dimensional reconstruction of CT saddle area and MRI-related data are used to guide the transnasal pituitary tumor resection before surgery, which helps to locate the anterior wall of the sphenoid sinus and the sella. It is helpful to fully remove the tumor and protect the internal carotid artery. High clinical value.