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目的探讨多模态神经导航影像融合功能在经蝶切除复发垂体腺瘤显微外科技术中的应用价值。方法采用多模态神经导航融合技术对25例复发垂体腺瘤患者行经蝶窦垂体腺瘤切除术,比较手术前后的影像学资料,判断肿瘤切除程度。结果肿瘤全切除18例,次全切除5例,大部分切除2例。无术后颅内感染、脑脊液漏或视力恶化;有短暂性尿崩伴有电解质紊乱11例,治疗后恢复正常。无手术死亡。结论在解剖结构破坏的情况下,利用神经导航引导准确到达病灶,影像融合技术可帮助术者确定肿瘤与骨性蝶窦及周边精细的解剖关系,缩短手术时间,最大限度切除肿瘤。
Objective To investigate the value of multimodality neural navigation image fusion in microsurgical techniques of transsphenoidal resection of pituitary adenoma. Methods 25 cases of recurrent pituitary adenomas underwent transsphenoidal pituitary adenoma resection using multimodality neural navigation fusion technique. The imaging data before and after operation were compared to determine the extent of tumor resection. Results Tumor resection in 18 cases, subtotal resection in 5 cases, most of the resection in 2 cases. No postoperative intracranial infection, cerebrospinal fluid leakage or deterioration of vision; transient uremic with electrolyte imbalance in 11 cases, returned to normal after treatment. No surgery died. Conclusions Under the condition of anatomical destruction, neural neutron guidance can accurately guide the lesion. Image fusion technique can help the operator to determine the fine anatomic relationship between the tumor and the bony sphenoid sinus and its surroundings, shorten the operation time and remove the tumor to the maximum extent.