垂体微腺瘤的诊断和治疗探讨

Discussion on the diagnosis and treatment of pituitary microadenomas

目的 探讨垂体微腺瘤 (直径≤ 5 mm)的诊断和治疗方法。方法 总结经 CT垂体薄层扫描加矢、冠状重建诊断的垂体微腺瘤 (直径≤ 5 mm) 2 8例 ,全部采用经口鼻蝶窦入路显微手术切除。随访临床资料和内分泌改变 ,定期复查 CT。 结果 2 8例中病理证实 2 6例为垂体腺瘤、1例为炎症、1例为增生 ,诊断符合率达到 92 .8%。病变的术中定位与 CT立体定位所见的位置完全符合。术后全部病例病情痊愈或好转 ,无手术死亡和并发症。 2 2例催乳素微腺瘤的内分泌治愈率为 90 .4% ,好转率为10 0 %。复查 CT未见复发。 结论 CT垂体薄层扫描加矢、冠状重建是诊断垂体微腺瘤和术中准确定位的可靠方法。经口鼻蝶窦入路垂体微腺瘤显微切除术是垂体微腺瘤治疗的可靠方法。

Objective To explored the diagnosis and treatment of pituitary microadenomas whose diameter equals or is less than 5 mm Methods This paper summarized twenty eight patients who had undergone contrast enhanced CT thin axial planes with coronal and sagittal reformatting All patients had undergone transsphenoidal microsurgery in our hospital Results All patients had low density lesion whose diameter equals or is less than 5 mm The position of low density lesion on CT and the focus which we found in surgery were very concord Twenty six patients were proved to be pituitary microadenomas, one was inflammation and the other one was ACTH hyperplasia by pathological examination All patients obtained good effect after surgery There were no death, no serious complications and hypopituitarism All of the patient had improved obviously in their endocrinology There are not recurrence in CT reexaminationed Conclusions We considered that contrast-enhanced CT thin axial planes with coronal and sagittal reformatting not only could make accurate localization, but also could make accurate diagnosis for pituitary microadenomas Transsphenoidal microsurgery is an important treatment for pituitary microadenoma