CT仿真内镜对鞍底的显示及在经蝶垂体瘤手术中的应用  

CTVE Images of Sellar Floor and Their Applications for Transsphenoidal Pituitary Surgery

作　　者：蔡梅钦[1] 秦峰[1] 邹艳[2] 李文胜[1] 胡冰[2] 王辉[1] 何海勇[1] 凌聪[1] 郭英[1] 

机构地区：[1]中山大学附属第三医院神经外科垂体瘤中心,广东广州510630 [2]中山大学附属第三医院放射科,广东广州510630

出　　处：《中山大学学报（医学科学版）》2009年第6期784-787,792,F0003,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2007B031003002)

摘　　要：【目的】探讨CT仿真内镜技术(CTVE)对鞍底的显示情况及其在经蝶手术中的应用价值。【方法】119例垂体瘤经蝶手术中,对术前常规CT检查数据进行CTVE及多平面重建(MPR),比较两种方法对鞍底的显示情况。通过传输函数设计容积重建技术透视鞍底,了解其深部颈内动脉的位置。【结果】CTVE能以三维图像的形式显示鞍底表面解剖结构,在119例蝶窦中共发现平坦形鞍底23个(19.3%)、球形鞍底96个(80.7%)、鞍底骨质破坏22个(18.5%)。通过CTVE的透视功能,能透过鞍底直接观察到鞍底深部增强的颈内动脉,在微腺瘤中同时能观察到增强的垂体组织。【结论】CTVE能以三维图像的形式显示鞍底的表面解剖结构,通过透视功能可透过鞍底显示深部的颈内动脉及部分垂体组织。对于垂体瘤经蝶手术,术前CTVE可帮助了解鞍底的三维解剖结构及手术计划的形成,术中可指导对鞍底辨认及鞍底骨窗的形成。[Objective] To evaluate the CTVE images of sellar floor and their applications to transsphenoidal pituitary surgery. [Methods] In 119 cases of transsphenoidal pituitary surgeries, the CTVE images of sphenoid sinus were reconstructed with the presurgical CT data at workstation, and then the sellar floors depicted on images were investigated. [ Results ] CTVE could display the sellar floors in a three-dimensional mode. In 119 cases of sphenoid sinus, CTVE could display 96 eases（80.7%） of prominent sellar bulge and 22 cases （18.5%） of eroded sellar floor. The underlying enhanced carotid arteries and some pituitary glands could be observed by transfer functions design for volume rendering. [Conclusion] CTVE can depict the superfical anatomical landmarks, the underlying carotid arteries and some pituitary tissues of sellar floor in a three-dimensional mode. CTVE can be a valuable tool for transsphenoidal pituitary surgery for depicting the variations of sellar floor, making preoperative planning, identifying the intraoperative anatomies and making a precise bone window of sellar floor during surgery.

关 键 词：CT仿真内镜 垂体瘤 经蝶入路 鞍底 

分 类 号：R445[医药卫生—影像医学与核医学]