垂体腺瘤数字化影像的构建及经单鼻孔-蝶窦入路手术模拟  

Construction of digital pituitary adenoma image and simulation of single nostril-transsphenoidal surgery

作　　者：张尚明[1] 王守森[1] 荆俊杰[1] 王如密[1] 钟群[2] 

机构地区：[1]南京军区福州总医院神经外科,福州350025 [2]南京军区福州总医院影像科,福州350025

出　　处：《中华神经医学杂志》2014年第2期160-164,共5页Chinese Journal of Neuromedicine

基　　金：南京军区医学科学技术研究十一五计划重点项目（06250）

摘　　要：目的构建垂体腺瘤的数字化影像，探讨其在经单鼻孔一蝶窦人路手术中的价值。方法南京军区福州总医院神经外科自2009年10月至2011年3月行单鼻孔一蝶窦人路切除术治疗垂体腺瘤患者30例，术前均行头颅CT和MR薄层扫描，将影像数据导人Dextroscope图形工作站进行融合重建，构建垂体腺瘤虚拟影像，观测相关解剖结构并模拟、规划手术。结果所创建影像可实现三维化，可动态、立体地观测相关解剖结构，可重复模拟手术：制定了鼻腔段、蝶窦前壁段、鞍底段及肿瘤周围的术前规划指标；对比实际手术情况，模拟手术基本可靠。结论垂体腺瘤虚拟影像能为单鼻孔．蝶窦入路手术提供一定的个体化解剖形态．用于制定术前规划方案．有助于手术的顺利开展，避免损伤重要的解剖结构。Objective To construct the digital pituitary adenoma image and explore the value of simulation of single nostril-transsphenoidal surgery. Methods Thirty patients with pituitary adenoma, admitted to our hospital from October 2009 to March 2011, were performed single nostril-transsphenoidal surgery; thin slice images of preoperative examinations included computed tomography and magnetic resonance imaging were imported into Dextroscope workstation to construct digital pituitary adenoma image; the related anatomic structures of surgical approach were observed and the procedures were formulated and performed. Results Models based on three-dimensional shapes could show the related anatomical structures dynamically and stereoscopically and simulate the operation process repeatedly. The preoperative planning indicators in the anatomic segment of nasal, anterior sphenoidal wall, basilar pituitary fossa and structures around the tumor were completed. The anatomic characteristics of simulated surgery were consistent with the real operation. Conclusions The digital models can provide some individual anatomic information to develop the preoperative planning programs for single nostril-transsphenoidal surgery, which can facilitate the work of operation and avoid injuring the important anatomical structures.

关 键 词：经鼻蝶入路 虚拟现实 解剖标志 

分 类 号：R736.4[医药卫生—肿瘤]