CT仿真内镜对蝶窦三维解剖的显示及在垂体瘤经蝶窦手术的应用

目的 探讨CT仿真内镜(CT virtual endoscopy,CTVE)显示蝶窦三维解剖的情况及在垂体瘤经蝶窦手术中的应用.方法 根据术前CT扫描数据重建蝶窦CTVE图像,并用于指导128例垂体瘤经蝶窦手术的术前计划及术中定位.结果 CTVE能显示蝶窦三维解剖结构,接近术中所见.在128例患者中,通过传输函数(tr...

CT virtual endoscopy images of sphenoid sinus and its applications in transsphenoidal pituitary surgery

OBJECTIVE To explore the usefulness of CT virtual endoscopy（CTVE）in displaying the three dimensional（3-D）anatomy of sphenoid sinus and transsphenoidal pituitary surgery.METHODS The CTVE images of sphenoid sinus were created from preoperative CT enhancement scanning data sets,and were applied to a series of 128 patients with pituitary tumor,who were operated via transsphenoidal route.RESULTS The CTVE images could indicate the 3-D anatomy of sphenoid sinus and were correlated well with intraoperative views.In 128 patients,CTVE could display internal carotid arteries（ICA）in 256（100%）cases and pituitary tissue in 24（18.7%）cases by TF;CTVE also could display optic canals（OC）in 255（99.6%）cases by gradually increasing the thresholds.So CTVE could simulate the procedures of sphenoidal septa removal,sellar floor exposure and opening.CTVE improved intraoperative orientation by depicting the superficial and underlying anatomies of sphenoid sinus,and provided an exact recognization and localization of important structures.CONCLUSION In transsphenoidal pituitary surgery,CTVE could be a valuable tool for displaying 3-D anatomical images,simulating surgery procedure,preoperative planning and introperative location.That is CTVE could increases surgical safety and accuracy.