Hamid Ossama, El Hakim Adel, El Husseiny Hossam, El Fiky Lobna, Kamel Sherif
Department Otorhinolaryngology, Ain Shams University, 50, El Hegaz Street, Heliopolis, Cairo, Egypt.
Department Neurosurgery, Ain Shams University, 18, El Mansoura Street, Heliopolis, Cairo, Egypt.
Indian J Otolaryngol Head Neck Surg. 2013 Aug;65(Suppl 2):231-5. doi: 10.1007/s12070-011-0350-3. Epub 2011 Nov 27.
Transsphenoidal approach is considered the treatment of choice for pituitary adenoma removal. Suprasellar extension is regarded a drawback for complete removal of these tumors through this approach. Evaluate the correlation between the preoperative radiologic craniocaudal extension on MRI of pituitary adenomas and the extent of tumor removal. A retrospective study. Tertiary care hospital. 560 patients underwent transsphenoidal removal of pituitary adenomas. The degree of removal of pituitary tumor in the follow-up imaging of the patients was correlated with the preoperative extension in mid-Coronal T1 W Gd. Tumors with suprasellar extension can be classified into: Type I tumors with extension confined to the sellar boundaries, resulted in complete removal in all cases (100%), type II tumors with suprasellar extension reaching the floor of the 3rd ventricle, resulted in complete removal in 70.2% of the cases, type III tumors with suprasellar extension above the 3rd ventricle, had only 13.5% of complete removal. Integration of radiologic findings into a scheme for the preoperative determination of possibility of total removal of the tumor through transsphenoidal approach, can give better correlation to the surgical outcome of pituitary tumors.
经蝶窦入路被认为是切除垂体腺瘤的首选治疗方法。鞍上扩展被视为通过该入路完全切除这些肿瘤的一个不利因素。评估垂体腺瘤术前MRI上矢状位颅尾径扩展与肿瘤切除范围之间的相关性。一项回顾性研究。三级医疗中心。560例患者接受了经蝶窦垂体腺瘤切除术。患者随访影像学中垂体肿瘤的切除程度与术前正中矢状位T1加权增强磁共振成像的扩展情况相关。鞍上扩展的肿瘤可分为：I型肿瘤扩展局限于鞍内边界，所有病例均实现完全切除（100%）；II型肿瘤鞍上扩展至第三脑室底部，70.2%的病例实现完全切除；III型肿瘤鞍上扩展超过第三脑室，仅13.5%实现完全切除。将影像学结果整合到一个术前确定经蝶窦入路完全切除肿瘤可能性的方案中，可更好地与垂体肿瘤的手术结果相关联。
