CHRU de Lille, Service d'Otologie et d'Otoneurologie, 59037 Lille cedex, France.
CHRU de Lille, Service de Radiologie, 59037 Lille cedex, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2017 Apr;134(2):117-120. doi: 10.1016/j.anorl.2016.09.003. Epub 2016 Oct 5.
The surgical management of skull base lesions is difficult due to the complex anatomy of the region and the intimate relations between the lesion and adjacent nerves and vessels. Minimally invasive approaches are increasingly used in skull base surgery to ensure an optimal functional prognosis. Three-dimensional (3D) computed tomography (CT) reconstruction facilitates surgical planning by visualizing the anatomical relations of the lesions in all planes (arteries, veins, nerves, inner ear) and simulation of the surgical approach in the operating position. Helical CT angiography is performed with optimal timing of the injection in terms of tumour and vessel contrast enhancement. 3D definition of each structure is based on colour coding by automatic thresholding (bone, vessels) or manual segmentation on each slice (tumour, nerves, inner ear). Imaging is generally presented in 3 dimensions (superior, coronal, sagittal) with simulation of the surgical procedure (5 to 6 reconstructions in the operating position at different depths).
颅底病变的手术治疗具有一定难度，因为该区域的解剖结构复杂，病变与相邻神经和血管之间的关系密切。微创手术方法在颅底外科中越来越多地被应用，以确保获得最佳的功能预后。三维（3D）计算机断层扫描（CT）重建通过在所有平面（动脉、静脉、神经、内耳）可视化病变的解剖关系，以及在手术位置模拟手术入路，有助于手术规划。螺旋 CT 血管造影术通过在肿瘤和血管增强方面优化注射时机来进行。基于自动阈值（骨、血管）或在每个切片上手动分割（肿瘤、神经、内耳）对每个结构进行 3D 定义。成像通常以三维（上、冠、矢状）呈现，并模拟手术过程（在不同深度的手术位置进行 5 到 6 次重建）。
