CT仿真内镜对蝶窦中隔的显示及其应用

CTVE images of sphenoid septa and their applications for transsphenoidal pituitary surgery

目的探讨CT仿真内镜(CT virtual endoscopy,CTVE)对蝶窦中隔的显示情况及其在经蝶手术中的应用价值。方法在119例垂体瘤经蝶手术中,对术前常规垂体CT检查数据进行CTVE及多平面重建(Multiplannar reconstruction,MPR),比较两种方法对蝶窦中隔的显示情况。通过传输函数设计容积重建技术(transferfunction volume rendering,TFVR)透视鞍底,了解蝶窦中隔与鞍底神经、血管的解剖关系。结果CTVE能以三维图像的形式显示蝶窦中隔,在119例蝶窦中共发现蝶窦中隔82.3%(98/119例)、间隔64.7(77/119例)、间嵴115.9%(138/119例),蝶窦中隔以偏向外侧壁为主。通过CTVE的透视功能,可观察到有42.8%(42/98例)中隔附着于颈内动脉的浅面。通过调高观察阈值,可观察到约17.3%(17/98例)中隔附着与视神经管表面。结论CTVE能以三维图像的形式显示蝶窦中隔及其与深部颈内动脉、视神经管的解剖关系。CTVE可用于术前了解蝶窦中隔的解剖关系,指导术中对蝶窦、鞍底及鞍底血管位置的辨认。

Objective To evaluate the CTVE images ofsphenoid septa and their value transsphenoidal pituitary surgery. Methods In 119 cases of transsphenoidal pituitary surgeries,the CTVE images of sphenoid sinus were reconstructed with the presurgical CT data at workstation,and then the sphenoid septa depicted on images were investigated. Results CTVE could display the sphenoid septa in a three-dimensional mode. 98 intersinus septa,77 small septa and 138 spurs were found in 119 cases of sphenoid sinus by CTVE. About 42.8% septa deviating laterally and terminating on the carotid arteries could be observed by transfer function volume rendering. About 17.3% intersinus septa terminating on the optic canals could be observed by heighten the threshold of CTVE. Conclusions CTVE can depict the sphenoid septa,their variations and the anatomical relation with underlying carotid artery and optic canal in a three-dimensional mode. CTVE can be a valuable tool for transsphenoidal pituitary surgery for depicting the sphenoid septa before the surgery and locating the anatomies during surgery.