垂体瘤鞍上生长与视力视野损伤程度的相关性

Correlation between suprasellar growth of pituitary tumor and the degree of vision and visual field injury

目的:基于3D slicer软件行垂体瘤鞍上生长重建对视力视野损伤程度的影响因素进行分析。方法:回顾性分析我院64例鞍上生长的垂体瘤患者,并根据视野检查结果的8个区域,将视野损伤等级分为无损伤、轻度损伤、中度损伤、重度损伤和极重度损伤5个等级的简易视野损伤评分。另外参照视力检查结果将视力损伤评分分为无损伤、轻度损伤、中度损伤、重度损伤、极重度损伤;基于3D slicer软件研究垂体瘤鞍上生长对视力视野损伤程度的影响,绘制ROC曲线分析相关因素在视力视野是否损伤的诊断价值。结果:同一眼睛视力视野损伤程度存在相关性,其中肿瘤鞍上矢状位角度、鞍上上下径、鞍上前后径、鞍上面积、鞍上体积组间具有统计学意义(P<0.05);视野损伤早期从颞上外侧开始,至颞下外侧、颞上内侧,最后至颞下内侧;鞍上矢状位角度在视力是否损伤的诊断价值较高。结论:基于3D slicer软件评估垂体瘤鞍上矢状位角度对视力损伤的影响具有一定价值。

Objective:To analyze the factors affecting the degree of vision and visual field injury based on a 3D slicer software which was used to reconstruct the suprasellar growth of pituitary tumor.Methods:Sixty-four patients with suprasellar pituitary tumors in our hospital were retrospectively assesed.According to eight areas of visual field examination,the visual field injury grade was divided into the following 5 grades:None,mild injury,moderate injury,severe injury,and most severe injury.In addition,the vision injury score was divided into none,mild injury,moderate injury,severe injury,and most severe injury.The 3D slicer software was used to study the effect of pituitary tumor growth on vision and visual field injury.ROC curve was drawn to analyze the diagnostic value of the related factors in vision and visual field injury.Results:The degree of vision and visual field injury of the same eye was correlated.The suprasellar sagittal angle,suprasellar craniocaudal diameter,suprasellar anteroposterior diameter,suprasellar area,and suprasellar volume were statistically significant among groups(P<0.05).Visual field injury in the early stage started from the lateral superior temporal to thelateral inferior temporal,themedial superior temporal,and finally,the medial inferior temporal.The suprasellar sagittal angle had a high diagnostic value in vision injury.Conclusion:The 3D slicer software is useful for evaluating the effect of the suprasellar sagittal angle on vision injury due to a pituitary tumor.