Grigoriev A Yu, Azizyan V N, Ivashchenko O V, Starkov G Yu
Endocrinology Research Centre.
A.I. Yevdokimov Moscow State University of Medicine and Dentistry.
Probl Endokrinol (Mosk). 2023 May 11;69(2):4-10. doi: 10.14341/probl13199.
Currently, the treatment of pituitary adenomas is inextricably linked with transsphenoidal neurosurgical intervention. Modern technologies used in surgery for this pituitary pathology, such as endoscopy using angled optics, as well as the use of specialized instruments, sealing and hemostatic materials, increase the effectiveness of surgical treatment of pituitary adenomas and reduce the incidence of intraand postoperative complications. The development of radiation methods of diagnostics, such as MRI, makes it possible to more accurately identify the formation of the pituitary gland, assess its size, direction of growth, and the degree of invasion of surrounding tissues. The authors of the article described in detail the modern technique of transsphenoidal removal of pituitary adenoma using an endoscope. Each stage of the operation is described step by step, taking into account various anatomical features and illustrated. This article discusses the MRI characteristics of pituitary adenomas: size of the tumor, the direction of its growth, the degree of invasion of the cavernous sinuses, the compression effect on the structures of the chiasmal-sellar region. The use of treatment methods, knowledge of the features of MRI diagnostics described in this article greatly increase the effectiveness of the treatment of patients with pituitary adenomas and reduce the risk of complications after neurosurgical intervention in such patients.
目前,垂体腺瘤的治疗与经蝶窦神经外科手术干预紧密相连。针对这种垂体病变的手术中所使用的现代技术,如使用角度光学内镜以及使用专门器械、密封和止血材料等,提高了垂体腺瘤手术治疗的有效性,并降低了术中和术后并发症的发生率。诊断性放射方法的发展,如磁共振成像(MRI),使得能够更准确地识别垂体肿物的形成,评估其大小、生长方向以及对周围组织的侵袭程度。文章作者详细描述了使用内镜经蝶窦切除垂体腺瘤的现代技术。考虑到各种解剖特征,对手术的每个阶段都进行了逐步描述并配有图示。本文讨论了垂体腺瘤的MRI特征:肿瘤大小、生长方向、海绵窦侵袭程度、对视交叉 - 鞍区结构的压迫效应。本文所述治疗方法的应用以及MRI诊断特征的知识,极大地提高了垂体腺瘤患者的治疗效果,并降低了此类患者神经外科手术后的并发症风险。