蝶窦间隔CT容积漫游技术重建对经蝶窦鞍区肿瘤切除术的作用

Effects of sphenoid sinus interval CT-VRT reconstruction on sphenoid sinus pituitary tumor resection

目的通过蝶窦间隔的容积漫游技术(VRT)重建了解蝶窦间隔形态的多样性以及与手术的相关性。方法 242例经蝶窦切除鞍区肿瘤的患者,术前用Siemens 128层螺旋CT行蝶窦间隔的VRT重建。结果 242例蝶窦间隔中,无间隔5例(2.1%);单间隔居中39例(16.1%);单间隔偏左78例(32.2%);单间隔偏右66例(27.3%);单间隔倾斜19例(7.9%);两间隔21例(8.7%);三间隔11例(4.5%);四间隔、多间隔、横隔各1例(各0.4%)。根据重建的蝶窦间隔,手术中98例(40.5%)能够定位鞍区肿瘤的位置。18例(7.4%)定位间隔与颈内动脉的毗邻关系,从而避免了动脉的损伤。3例(1.2%)复杂间隔,指示间隔的切除范围及方向,尽快暴露鞍底。结论重建的蝶窦间隔能指导手术操作,提高手术精确性及安全性。

Objective Sphenoid sinus interval CT-VRT reconstruction has acquired the diversity of sphenoid sinus interval forms and the surgery-related correlation. Methods This paper has reviewed 242 cases of transsphenoidal sellar tumor removal patients, and prior to the surgery sphenoid sinus interval VRT by Siemens-128CT has been reconstructed. Results Among 242 cases there were 5 no-interval cases （2.1%）, 39 single-interval centered cases（16.1%）, 78 left-sided single interval cases （32.2%）, 66 right-sided single interval cases （27.3%）, 19 tilted single-interval cases （7.9%）, 21 double-interval cases （8.7%）, 11 three-interval cases and 1 four-interval case, 1 multi-interval and 1 cross-interval case （0.4%respectively）. Based on sphenoid sinus interval CT-VRT reconstruction, the positions of sellar tumor in 98 cases （40.5%） had been located, the neighboring relations between sphenoid sinus interval and interval carotid in 18 cases （7.4%） had been defined, which can help avoid unnecessary injuries, and the removal areas and directions of complicated intervals in 3 cases had been certified to expose the sellar. Conclusion Sphenoid sinus interval CT-VRT reconstruction can help guide sellar tumor removal surgeries and improve the precision and security.