核磁共振多平面重建在鞍区肿瘤显微手术入路选择的意义

The value of using multiple planar reconstruction technique to help selecting microsurgical approach for sellar tumors

目的报道核磁共振多平面和曲面重建技术在鞍区占位病变对鞍区重要结构的显示效果和探讨其在显微外科手术入路选择的作用。方法通过应用核磁共振和核磁共振多平面重建技术对鞍区常见肿瘤进行术前检查,重建鞍区病变和周围重要结构整体解剖三维切面,显示视神经、视交叉、垂体柄和视丘部等的三维结构,指导手术计划。结果13例鞍区肿瘤通过核磁共振多平面重建技术能清楚显示受肿瘤压迫移位的视神经、视交叉、动眼神经、视丘部和垂体柄等结构。其中垂体瘤8例、颅咽管瘤3例、鞍结节脑膜瘤2例均获全切除。结论核磁共振多平面重建技术在显示鞍区整体结构的效果良好,术前应用核磁共振多平面重建技术检查鞍区病变有助于其显微外科手术入路的选择。

Objective Using Multiple Planar Reconstruction （MPR） technique to display the important structures of sellar region and to help selecting the microsurgical opproach for sellar tumors. Method All patients took MRI scanning and made use of MPR technique to reconstruct the three-dimensional slies of neoplasmas and important anatomic structures around sellar region before operation. Using this technique to display the three-dimensional structures of optic nerves,optic chiasm, pituitary stalk and hypothalamusin and to map out a operation plan. Results MPR technique can clearly display Ⅱ , Ⅲ cranial nerves,optic chiasm,pituitary stalk and hypothalamusin in all 13 sellar region tumors. Mostly of the structures was pressed by tumors and shift from the original region. Total resection was performed in 8 pituitary adenomas,3 craniopharyngiomas and 2 meningiomas of tuberculum sellae. Conclusion MPR technique can display the whole three-dimensional anatomic structures of the sellar region and is helpful for selecting microsurgical approach to sellar region.