蝶鞍区CT三维重建在经单鼻孔蝶窦入路垂体瘤切除术中的应用

The study on significance of three dimensional reconstruction of CT scan of the sellar region in transsphenoidal microsurgery for pituitary adenoma

目的探讨蝶鞍区CT三维重建在经单鼻孔蝶窦人路垂体瘤切除术中的作用。方法应用多层螺旋CT和AQI影像工作站对54例垂体瘤患者术前进行蝶鞍区CT薄层扫描、三维重建，观察蝶窦气化类型、分隔情况、蝶窦与鞍底的关系，并与术中实际情况进行对比验证。结果蝶窦双侧气化程度相同者24例，气化不同者30例。蝶窦分隔呈正中矢状位者14例；偏左者15例；偏右者19例；其他类型（包括不同程度斜位，横位等）6例。蝶窦位于鞍底中线之前者12例，蝶窦位于鞍底中线下方者32例，蝶窦位于鞍底中线之后者10例。结论蝶鞍区CT三维重建可简单、直观、准确的反映每例患者蝶窦形态及其与周围毗邻结构的关系。为术者提供更加完整和实用的影像学信息．

Objective To study the significance of three dimensional reconstruction of CT scan of the sellar region in transsphenoidal microsurgery for pituitary adenoma. Methods Multi - slice spiral CT scan and three dimensional reconstruction and AQI image workstation were used in 54 patients with pituitary adenoma. The pneumatization classification and septum of sphenoid sinus, image data were further proved and compared with the real anatomy of sphenoidal sinuses during the microneurosurgical procedure. Results The sphenoid sinuses were found to be identical type of pneumatization in 24 cases and non - identical in 30 cases. According to the vertical line drawed from the central point of the sella floor, the septums of sphenoidal sinus were located in midline in 14 cases, in left side in 15 cases, in right side in 9 cases. Transverse - or oblique - oriented septums were found in 6 cases. Classification of sphenoidal sinus were established according to the vertical line drawed from the central point of the sella floor to Nassion line, and the sphenoid sinuses were located in front of the vertical line in 12 cases, under the vertical line in 32 cases, and behind of the vertical line in 10 cases . There was statistical variation in individual. Conclusions The three dimensional reconstruction of CT scan can accurately show the shape and adjacent structures of sphenoidal sinus and aid in transsphenoidal microsurgery for pituitary adenoma.