MSCT evaluation of endonasal transphenoidal microsurgery for pituitary adenoma / 实用放射学杂志

ABSTRACT

Objective To explore the feasibility and value of MSCT for the evaluation of hypophysoma before and after endonasal transphenoidal microsurgery.Methods 82 patients with hypophysoma intended to be treated by endonasal transphenoidal microsur-gery,were examined by 64-slice head CT angiography (CTA).All the images were transmitted to workstation and reconstructed by MIP、VR and MPR.The hypophysoma were typed according to the relationship between hypophysoma and its surrounding vessels. The shortest and longest diameter between internal carotid arteries of two sides,tumor length and width,the diameter between ex-ternal naris and the rear wall of sphenoid top and the length from external naris to the rear wall of tumor top were measured in VR images.Sphenoid division was observed in coronal plane image.Major vascular injury,bleeding,and residual tumor situation were observed on postoperative CT review.The surgery effect was evaluated by three associate professorwith SPSS 13.0.Results 39 ca-ses were type-A,30 were type-B,13 were type-C,tumor length ranged from 1.7 cm to 3.9 cm,width ranged from 1.3 cm to 2.5 cm,the diameter between external naris and the rear wall of sphenoid top and the length between external naris and the rear wall of tumor top were 6.9 cm~7.6 cm and 9 cm~12.2 cm.There are 1 5 cases of sphenoid without division,34 cases with one divi-sion,26 cases with two division and at least three division in 7 cases.The surgery effect was better in those which tumor size was relatively smaller compared to the diameter of the internal carotid artery.The evaluation of endoscopic endonasal transsphenoidal surgery with three types of pituitary adenomas had a significant difference (P <0.05).Conclusion MSCT can preferably reflect the spatial location relationship between pituitary adenimas and its surrounding structure,and it is effective evaluation methods for pre-operative and postoperative evaluation of transnasal microsurgical resection.