经蝶窦摘除垂体腺瘤术后蝶鞍CT影像的分析

Analysis of the Sellar CT Images after Removal of Pituitary Adenoma by the Transsphenoidal Approach

目的通过ＣＴ影像的追踪观察，正确地判断垂体腺瘤的手术疗效，方法观察１０２例经蝶窦摘除垂体腺瘤术后蝶鞍的ＣＴ影像。结果早期蝶鞍内密度增高可能是由于出血、填塞的肌肉片、含有生物胶的明胶海绵或残有的肿瘤所致，即使增强扫描也难以区别；后期至晚期连续ＣＴ扫描的价值较大，能区分填塞物、残瘤或肿瘤复发。结论植入鞍内的组织不同，其密度亦有差异，且随时间延长而变化。术后应ＣＴ追踪观察蝶鞍区的影像，并结合临床综合评估手术疗效。

Objective To assess the operative result for pituitary adenomas with CT.Methods The sellar CT images from 102 cases of pituitary adenoma after tumor removal by the transsphenoidal approach were investigated consecutively.Results In the early postoperative stage,intrasellar high density on CT scans might be attributed to hemorrhage,stuffed-in muscle tissue,gelfoam immersed with biological glue or tumor residual,and it was difficult to identify what it was even on enchanced scans. But in the late postoperative stage,consecutive CT scanning was found to be valuable in distinguishing among wadding, tumor residual and tumor recurrence within sella turcica.Conclusion Density of different intrasellar substances implanted during the operation changes chronologically.therefore,combined with clinical outcome,continual postoperative CT follow-up should be applied to observe the change of the sellar region image.