多模态影像融合神经导航在经蝶垂体腺瘤手术中的应用

Application of multimodal image fusion navigation in transsphenoidal pituitary adenoma surgery

目的探讨多模态影像融合神经导航(MIFN)在经蝶垂体腺瘤手术中的应用价值。方法垂体腺瘤患者59例在神经导航指引下行经蝶手术。利用MRI和CT融合图像制定导航计划,引导手术进程。结果 59例垂体腺瘤在MIFN下均能准确和快速定位病变,为手术的准确性和安全性提供保障。肿瘤全切除46例,次全切除13例。无手术死亡,无术后颅内感染和出血,无脑脊液漏。术后一过性尿崩11例,伴有电解质紊乱5例,3例术后垂体功能低下。随访3-18个月,7例次全切患者肿瘤复发。结论 MIFN技术用于经蝶垂体腺瘤手术能增加肿瘤的显露,提高肿瘤切除率,缩短手术时间,避免因定位偏差对周围重要结构造成损伤,减少术后并发症。

Objective To investigate the application of multimodal image fusion of neuronavigation（MIFN）in the operation of transsphenoidal pituitary adenoma.Methods Transsphenoidal pituitary surgery for adenoma was performed in 59 patients,which was guided by MIFN including MRI and CT fusion images for making a navigation plan and guiding surgical procedures.Results MIFN could provide an accurate and quick localization of the lesions in all cases and guarantee the accuracy and safety for operations.Of 46 cases,total tumor resection was performed in 46 cases and subtotal resection in 13 case.There were no cases with postoperative intracranial infection or hemorrhage,cerebrospinal fluid leakage and death.Postoperative transient diabetes insipidus occurred in 11 cases,electrolytes disorder in 5 cases,postoperative hypopituitarism in 3 cases.The patients were followed up for 3-18 months,during which tumor recurrence was seen in 7 cases.Conclusion Application of MIFN for the surgery of transsphenoidal pituitary adenoma has the advantages of improving tumor resection rate,shortening operation time,avoiding the injury of important tissues surrounding tumors from positioning deviation,and reducing postoperative complications