无功能垂体大腺瘤经蝶窦入路手术后核磁共振随访

MR imaging after transsphenoidal surgery of clinically nonfunctional pituitary macroadenomas

目的探讨无功能垂体大腺瘤经蝶窦入路手术后MRI随访的最佳时间。方法回顾性分析50例,分别在术前、术后1周内(早期)、术后3月(中期)、术后1年(后期)的MRI资料。观察术后不同时期MRIT1增强前后鞍内容物的变化及判断肿瘤切除的程度。结果术后早期MRI检查显示多数患者鞍区内容物明显减少,其中28例无法判别残余肿瘤,术后3月后鞍区内容物体积减少,MRI冠状位上鞍区内容物体积减少50%以上的11例,减少30-50%的9例,小于30%的8例。有23例于术后3个月后MRI检查确诊鞍区有残余肿瘤。结论无功能垂体大腺瘤经蝶窦入路术后中期复查MRI容易判断肿瘤残余或复发。

Objective To explore the best time for the MR imaging follow-up after transsphenoidal surgery of clinically nonfunctional pituitary macroadenomas. Methods 50 patients with non-functional pituitary macroademomas examined by MRI before and after 1 week (early MR)、months (intermediate MR) and 1 year (late MR) of the transsphenoidal surgery were analysed retrospectively. Dynamic changes in the sellar contents over time and the degree of tumour excision were studied on MRI T1-weighted enhanced and unenhanced scans. Rusults Compared with preoperative MRI, early post-operative images showed the size of sellar contents decreased in most of cases.The residual tumors are not decided in 28 cases. The mass in the sella decreased 3 months after operation, resulting in above 50 % changes in the volume of the coronal sellar extension in 11 eases, 30 - 50 % in 9 cases, less than 30 % in 8 cases. The residual tumor tissue was detected in 23 cases by MRI 3 months after operation. Conclusion The intermediate MR follow-up is an important factor to determine residual tumors after transsphenoidal surgery of clinically nonfunctional pituitary macroadenomas.