三维CT重建与MRI联合应用于经单鼻孔-蝶窦入路垂体腺瘤显微手术切除术中的临床价值  

The clinical value of multi-detector spiral CT(MDCT) with three-dimensional reconstruction and MRI in the single-nostril transsphenoidal pituitary adenomectomy

作　　者：黎乾科[1,2] 姚庆宁[1,2] 唐协林[1,2] 肖奎[1,2] 夏祥国[3] 钟俊[1,2] 刘胜华[1,2] 赵超[1,2] 

机构地区：[1]四川省三台县人民医院 [2]川北医学院附属三台医院神经外科,四川三台621100 [3]泸州医学院附属医院神经外科,四川泸州646000

出　　处：《中国现代医生》2014年第36期120-123,F0003,共5页China Modern Doctor

摘　　要：目的评价三维CT重建与MRI联合应用于经单鼻孔-蝶窦入路垂体腺瘤显微手术切除术的价值。方法对100例临床怀疑脑垂体瘤患者术前常规进行头颅MRI平扫＋强化或动态强化＋多排螺旋CT薄层扫描并三维重建,应用于经单孔-蝶窦入路垂体腺瘤显微手术切除术术中定位,确定手术入路的角度、深度、安全操作范围。结果术前提供影像信息可靠,术中定位准确。肿瘤全切除85例,次全切除10例,大部切除5例。手术用时30-75 min,平均40 min。术后患者临床症状均有不同程度恢复,并发症少,无手术死亡。总治愈率69%,治愈缓解率90%。结论术前三维CT重建联合MRI应用于经单鼻孔-蝶窦入路手术,有助于提高肿瘤全切率及手术疗效。Objective To assess the clinical value of Muhi-detector Spiral CT（MDCT）with three-dimensional recon- struction and MRI in the single-nostril transsphenoidal pituitary adenomectomy. Methods MDCT scan, MRI and MR enhancement（or contrast-enhancement） were performed in 100 patients with suspected pituitary adenoma. MDCT with three-dimensional reconstruc-tion and MRI were applied to guide the approach,to judge the safety point of view and depth and the scope of security. The retrospective analysis was performed in the patients with pituitary adenoma treated by microsurgical technique through single nostril-sphenoid sinus approach. Results Muhi-detector Spiral CT with Three-dimensional reconstruction and MRI provided reliable information. Loction of operation could be accurately de- termined.Total removal was achieved in 85 cases,subtotal removal was achieved in 10 cases,and most tumor removal was achieved in 5 cases. Time of the operation lasted in 30-75 minutes; The average time of the operation was 40 minutes. Clinical symptoms of patients after operation in some degree were improved, and there were fewer complica- tions ,and no cases of death. The cure rate was 69% ;The cure and remission rate was 90%. Conclusion The three-di- mensional CT reconstruction with MRI for single-nostril-transsphenoidal pituitary adenoma microsurgical resection con- tributed to improving the rate of tumor resection, and surgical effect.

关 键 词：三维重建 MRI 经单鼻孔-蝶窦入路 显微手术 垂体腺瘤 

分 类 号：R736.4[医药卫生—肿瘤]