CT仿真内镜与多平面重建对垂体瘤患者蝶窦显示情况的比较

Comparison of the images of the sphenoid sinus reconstructed by CT multiplannar reconstruction and CT virtual endoscopy

目的:比较CT仿真内镜(CT virtual endoscopy,简称CTVE)与CT多平面重建(multiplannar reconstruction,MPR)对垂体瘤患者蝶窦、鞍底的显示情况。方法:在119例垂体瘤经蝶手术中,对术前常规垂体CT检查数据分别进行MPR及CTVE重建,对两者显示的蝶窦情况进行比较。结果:在蝶窦表面解剖结构:蝶窦开口、蝶窦中隔、鞍底形状、斜坡凹陷、颈内动脉隆起、视神经管隆起方面,CTVE与MPR的显示率无明显差别,CTVE对颈内动脉视神经隐窝的显示率优于MPR,CTVE所提供的为三维图像,MPR提供的为二维图像。在显示深部解剖标志:斜坡松质骨、蝶窦壁厚度方面MPR明显优于CTVE。结论:CTVE能显示蝶窦浅表解剖结构的三维图像,可做为经蝶垂体瘤手术的术前了解蝶窦三维解剖结构的一种方法。

Objective： To compare images of the sphenoid sinus reconstructed by CT multlplannar reconstruction （ MPR）and CT virtual endoscopy （CTVE）. Methods： For 119 patients with pituitary adenomas underwent microsurgery via transphenoidal approach, the presurgical CT data was transformed to work station, the anatomical images of the sphenoid sinus were then reconstructed by multiplannar reconstruction and CT virtual endoscopy respectively, and then the images reconstructed by these two methods were compared. Pesulta： The superficial anatomic structures of sphenoid sinus, such as sphenoid ostia, sphenoid septae, sellar floor, carotid prominences, optic prominences and the opticocarotid recesses could be displayed in a three dimensional mode by CTVE. Except for the opticocarotid recesses, the display rate of above superficial structures were similar between CTVE and MPR. For the exposure of deep structures, such as the candellated bone of the clivus and thickness of the wall of the sphenoid sinus, the MPR was superior to CTVE. Conclusions： CTVE can display the three dimensional anatomies of sphenoid sinus and the landmarks of sellar floor. It is a valuable tool to study the individual anatomies of the sphenoid sinus before transsphenoidal pituitary surgery