CT后处理技术对内镜下垂体瘤切除术的应用研究

Study on Application of Technology of Endoscopic Pituitary Tumor Resection After CT Treatment

[目的]探讨多层螺旋CT后处理技术对内镜下垂体瘤切除术的应用价值。[方法]对58例经鼻内镜下垂体瘤切除术的患者,术前采用CT(Siemens 64层)行鞍区(包括全鼻腔、鼻窦)CT薄扫,并在Siemens Syngo工作站进行图像后处理,包括鼻腔、鼻窦三维多平面重建(MPR)及CT仿真内镜(CTVE),并观察图像处理结果在手术中的应用价值。[结果 ]通过CTVE可以在术前模拟进入鼻腔,可以提供鼻腔和鼻窦的精细解剖和病变范围的准确信息,同时观察软组织窗3DCT图像,优化内镜进入路径。CTVE比术中内窥镜能更形象、更细致地显示鞍底解剖结构,对蝶窦中隔、鞍底、斜坡等结构的显示范围较术中内窥镜大。[结论]内镜下垂体瘤切除术前应用多层CT后处理技术可以显示蝶窦和鞍底的解剖标志及内部结构的三维解剖关系,可以指导术中定位,提高手术操作的安全性及可行性。

[Purpose] To explore the application value of multi-slice spiral CT post-processing technique of endoscopic resection of pituitary tumors. [Methods] In 58 cases of patients with nasal endoscopic pituitary tumor resection,preoperative CT（Siemens 64） for sellar region（including nasal,paranasal sinus CT scan）,and image in Siemens Syngo workstation,including nasal sinus,three-dimensional multiplanar reconstruction（multiplanar reconstruction MPR） and CT（virtual endoscopy CT virtual endoscopy,CTVE）,and to observe the results of image processing in the application value of operation.[Results] The CTVE in the preoperative simulation can provide accurate information into the nasal cavity,the nasal cavity and paranasal sinus fine anatomy and lesion range,observe the soft tissue window 3DCT image at the same time,the optimization of endoscopic access path. Compared with intraoperative endoscope CTVE can be more vivid,more detailed display of sellar anatomy,the septum of sphenoidal sinus,sellar floor,slope structure display range than intraoperative endoscope. [Conclusion] The application of multilayer CT resection of pituitary tumors before and after endoscopic treatment technology can display the anatomy of the sphenoid sinus and saddle bottom anatomical relationship sign and internal structure,can guide the intraoperative positioning,improve the safety and feasibility of operation.