MRI引导下经蝶窦垂体腺瘤手术的临床应用

Clinical Application of MRI Guided Trans-sphenoidal Surgery for Pituitary Adenoma

目的:探讨运用术前MRI图像引导经蝶垂体腺瘤手术的临床应用价值。方法:对42例垂体腺瘤患者于术前在工作站中进行MRI图像三维重组,制定手术计划,标记重要结构,术中应用MRI影像定位并指导手术操作。结果:所有患者在MRI影像引导下手术均获成功,术中定位精确,误差在0～1.9mm。术后MRI复查确定为肿瘤全切除者34例(80.9%)、次全切除者8例(19.1%)。结论:MRI图像是进行垂体腺瘤引导手术最适合的基础图像,高、低场MRI图像均能够满足要求从而完成手术。

Objective：To assess the efficacy of pre-surgical MRI neuro-navigation system guided trans-sphenoidal re section of pituitary adenoma. Methods： 42 patients with pituitary adenoma underwent MR scanning before surgery. 3D image reconstruction,operation planning and marking of important anatomic structures were finished in the workstation of navigation system. All of the operation procedures were done under the guidance of MRI navigation system. Results： All of the MRI guided operation were successful, tumors were accurately localized with neuronavigation system,the mean error ranged from 0- 1.9mm. Complete resection was revealed in 34 cases （80.9%） and subtotal resection in 8 cases （19.1%） on postoperative follow up MRI. Conclusion： MRI neuro-navigation system is the first choice imaging modality in guiding transsphenoidal surgery for pituitary adenoma,images by high or low field MR scan fulfilled the requirement of neuronavigation.