虚拟内镜技术在内镜经鼻蝶入路垂体瘤切除术中的运用  

Virtual endoscopy in endoscopic pituitary tumor resection through the endonasal transsphenoidal approach

作　　者：蒋伟平[1] 陈祎招[1] 林波森[2] 徐如祥[3] 王向宇[1] 罗成义[1] 李兵[1] 

机构地区：[1]南方医科大学珠江医院神经外科,广东省神经外科研究所,广东省脑功能修复与再生重点实验室,广州510282 [2]南方医科大学珠江医院放射科,广州510282 [3]北京军区总医院神经外科,北京100700

出　　处：《中华神经医学杂志》2011年第2期185-188,共4页Chinese Journal of Neuromedicine

基　　金：广东省适宜卫生技术推广项目[（2010）152]

摘　　要：目的 运用虚拟内镜（VE）技术观察内镜经鼻蝶入路的解剖结构,探讨其对内镜经鼻蝶入路垂体瘤切除术的指导价值. 方法 南方医科大学珠江医院神经外科自2007年12月至2010年3月行内镜经鼻蝶入路垂体瘤切除术患者21例,患者术前均采用64排CT扫描及VE图像重建.比较术前VE和术中内镜图像并分析经鼻蝶入路中解剖结构累加分值的相关性. 结果 术前VE图像与术中神经内镜图像非常相似;解剖结构的相符性良好,术前VE和术中内镜下8个解剖结构显示的累加分值具有正相关关系（r=0.923,P=0.001）;调整VE的位置可以模拟神经内镜经鼻蝶入路垂体瘤切除术,观察内镜下经鼻蝶入路的解剖结构. 结论 VE能于术前准确直观地显示内镜经鼻蝶入路的重要解剖结构及变异,指导术前计划形成,提高手术效率,增加手术操作的安全性.Objective To observe the anatomical structure via endonasal transsphenoidal approach with virtual endoscopy （VE） and explore the clinical applications of VE in endoscopic pituitary tumor resection through the endonasal transsphenoidal approach. Methods The VE was applied to the reconstruction of the pre-surgical 64-slice CT scanning of the 21 patients with pituitary adenoma received the endoscopic endonasal transsphenoidal surgery. A comparative study and a correlation analysis of cumulative scores of the anatomical structure were performed between the reconstructed VE images and the intraoperative endoscopic ones. Results Preoperative VE images and intraoperative endoscope images are very similar. The correlation of cumulative scores of the anatomical structure between the VE images of anatomical findings and the intraoperative images was positively noted （r=0.923, P=0.001）,indicating that VE can be applied to simulately observe the anatomical structure before the endoscopic endonasal transsphenoidal pituitary surgery, and observe the anatomical structure through the endonasal transsphenoidal approach. Conclusion Being able to display the important anatomical structure and its varieties before the endoscopic endonasal transsphenoidal pituitary surgery, VE proves to be a valuable approach to the preoperative planning, increases the surgical efficiency and improves the safety of the surgery.

关 键 词：神经内窥镜 垂体腺瘤 虚拟内镜 

分 类 号：R736.4[医药卫生—肿瘤]