MRI诊断侵袭性垂体腺瘤的特征分析及内镜下双鼻孔入路的手术效果观察  

Characteristics Analysis of MRI in the Diagnosis of Invasive Pituitary Adenomas and Effect Observation of the Surgical Effect of Endoscopic Double Nostril Approach

作　　者：王艳军[1] 赵德彩[2] 孙政[1] 张鹏 路磊[3] WANG Yanjun;ZHAO Decai;SUN Zheng;ZHANG Peng;LU Lei(Department of Neurosurgery,The People’s Hospital of Bozhou,Bozhou 236800,Anhui,P.R.China;Department of Anesthesiology,The People’s Hospital of Bozhou,Bozhou 236800,Anhui,P.R.China;Department of Traumatic Orthopedics,The People’s Hospital of Bozhou,Bozhou 236800,Anhui,P.R.China)

机构地区：[1]亳州市人民医院神经外科,安徽亳州236800 [2]亳州市人民医院麻醉科,安徽亳州236800 [3]亳州市人民医院创伤骨科,安徽亳州236800

出　　处：《影像科学与光化学》2023年第1期90-95,共6页Imaging Science and Photochemistry

基　　金：2020年度国家自然科学基金青年科学基金项目(82003795)。

摘　　要：本研究探讨侵袭性垂体腺瘤的磁共振成像(MRI)特征及采取内镜下双鼻孔入路实施手术治疗的临床效果。选取35例侵袭性垂体腺瘤患者作为侵袭组、25例同期非侵袭性垂体腺瘤患者作为非侵袭组,对比两组的MRI影像学特征参数差异。两组患者均采用内镜下双鼻孔入路实施手术治疗,观察患者手术效果及血清生长激素、催乳素水平的变化情况。侵袭组患者主要为大腺瘤、巨大腺瘤,非侵袭组主要为微腺瘤(P<0.05)。侵袭组患者与非侵袭组患者的泌乳素(PRL)腺瘤、促肾上腺皮质激素(ACTH)腺瘤、生长激素类(GH)腺瘤、混合型腺瘤、非功能性垂体腺瘤构成情况比较,差异无统计学意义(P>0.05)。侵袭组患者主要为慢速上升型、平台型时间-信号强度曲线,非侵袭组患者主要为快速上升型时间-信号强度曲线(P<0.05)。两组患者术后1周、术后1个月的血清生长激素、催乳素水平较术前均显著降低(P<0.05)。侵袭组患者的总体临床疗效与非侵袭组患者的比较,差异无统计学意义(P>0.05)。侵袭性垂体腺瘤肿瘤病灶一般大于非侵袭性垂体腺瘤,MRI时间-信号强度曲线以慢速上升型时间-信号强度曲线、平台型时间-信号强度曲线为主,且采用内镜下双鼻孔入路实施手术治疗侵袭性垂体腺瘤、非侵袭性垂体腺瘤均具有较好的效果。This study investigated the magnetic resonance imaging(MRI)features of invasive pituitary adenomas and the clinical effects of endoscopic bilateral nostril approach.35 patients with invasive pituitary adenoma were selected as the invasive group,and 25 patients in the same period with non-invasive pituitary adenoma were selected as the non-invasive group.The differences of MRI imaging parameters between the two groups were compared.Both groups were treated by endoscopic double-nostril approach,and the surgical effect and changes of serum growth hormone and prolactin levels of patients were observed.The invasive group was mainly characterized by large adenoma and giant adenoma,while the non-invasive group was mainly characterized by microadenoma(P<0.05).There was no significant difference in the composition of prolactin(PRL)adenoma,adrenocorticotropic hormone(ACTH)adenoma,growth hormone(GH)adenoma,mixed adenoma and non-functional pituitary adenoma between the invasive group and the non-invasive group(P>0.05).Patients in the invasion group mainly showed slow rising time-signal intensity curve and plateau time-signal intensity curve,while patients in the non-invasion group mainly showed rapid rising time-signal intensity curve(P<0.05).The serum levels of growth hormone and prolactin in the two groups at 1 week and 1 month after operation were both significantly lower than those before operation(P<0.05).There was no significant difference in the overall clinical efficacy between the invasive group and the non-invasive group(P>0.05).The tumor lesion of invasive pituitary adenoma was generally larger than that of non-invasive pituitary adenoma.The time-signal intensity curve of MRI was mainly of slow-rising type and plateau type,and endoscopic double-nostril approach for the treatment of invasive pituitary adenoma and non-invasive pituitary adenoma had a good effect.

关 键 词：侵袭性垂体腺瘤 磁共振成像 内镜 双鼻孔入路 生长激素 催乳素 

分 类 号：R445.2[医药卫生—影像医学与核医学] R736.4[医药卫生—诊断学]