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目的 探讨垂体腺瘤的MRI表现对判断肿瘤质地的意义 ,侵袭性腺瘤的判断 ,以及经蝶入路切除垂体腺瘤的可行性和有效性。方法 回顾分析 2 0 0例经蝶入路手术垂体腺瘤患者的临床资料、MRI信号特点及手术情况。结果 138例T2 像为高信号 ,肿瘤质软 ;T2 像呈稍高信号 2 4例 ,质地中等 ;T2 像呈等、低信号 38例 ,肿瘤质韧。术中发现有侵袭征象 12 6例 ,病理报告显示 139例鞍底硬膜被肿瘤侵袭 ,5 2例蝶窦粘膜有肿瘤侵袭。手术全切除肿瘤 170例 ,次全切除 17例 ,部分切除 13例。术前有视力障碍的患者 ,98%术后得以改善 ;功能性腺瘤患者术后 95 %以上激素水平恢复正常 ;无严重并发症。结论 MRI检查T2 像信号强度与垂体腺瘤的质地有关 ,显微镜下的侵袭性大多数在术中也可发现侵袭的征象 ;经蝶入路显微切除垂体腺瘤 ,即使是巨大腺瘤也是安全有效的。
Objective To investigate the MRI findings of pituitary adenoma to determine the significance of tumor texture, the judgment of invasive adenoma and the feasibility and effectiveness of transsphenoidal approach in resecting pituitary adenoma. Methods A retrospective analysis of 200 patients with transsphenoidal pituitary adenoma surgery clinical data, MRI signal characteristics and surgical conditions. Results 138 cases of T2 images were hyperintense and the tumors were soft. The T2 images showed slightly higher signal in 24 cases with medium texture. The T2 images showed equal and low signal in 38 cases. Intraoperative findings were 126 cases of invasive signs, pathological reports showed 139 cases of saddle dura tumor invasion, 52 cases of sphenoid sinus mucosa tumor invasion. Surgical resection of the tumor 170 cases, subtotal resection in 17 cases, partial resection in 13 cases. 98% of patients with visual impairment before surgery can be improved; more than 95% of patients with functional adenoma hormone levels returned to normal; no serious complications. Conclusions The intensity of signal intensity of T2 examination by MRI is related to the texture of pituitary adenoma. Most of the invasiveness under microscope can also be found in the operation. The microsurgical removal of pituitary adenoma by transsphenoidal approach is safe even for giant adenoma Effective.