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目的通过对垂体腺瘤病人的蝶鞍进行MRI测量,分析相关的影响因素和临床意义。方法连续收治并筛选垂体大腺瘤40例,直径大于10 mm,鞍底轮廓均完整。取正中矢状位和冠状位的蝶鞍MRI进行测量,主要指标包括鞍长、鞍面、鞍凸、鞍角、鞍窗、肿瘤高度、鞍上和鞍下部分肿瘤的高度、鞍上和鞍下部分肿瘤的面积等,将其相互对比,并与蝶窦的气化程度及肿瘤切除程度作比较。结果凸型鞍底(鞍角<90°)为29例,弧型(鞍角为90°~150°)10例,扁平型(鞍角>150°)1例。肿瘤大小与鞍长、鞍面、鞍窗均存在明显正相关(P<0.01),其中肿瘤大小与鞍长的相关性最为显著。鞍下部分肿瘤高度与鞍凸呈正相关(P<0.05),两者均与蝶窦气化类型之间无明显关系。鞍凸和鞍角均为较独立的观测指标,与鞍面、鞍窗及鞍长关系不大。结论垂体腺瘤越大,蝶鞍也趋于增大,特别是使鞍底更为隆突。在半鞍型蝶窦者,尽管鞍底较为扁平,但是因为伴有较大的鞍长和鞍窗,展开鞍底开窗手术操作的难度并不大。
Objective To analyze the influencing factors and clinical significance of the sella of pituitary adenoma through MRI. Methods Forty cases of pituitary adenomas were treated consecutively and screened. The diameters of the pituitary adenomas were more than 10 mm, and the contours of the saddle were all intact. The median sagittal and coronal MRI was performed on the sellae. The main parameters included saddle length, saddle, saddle, saddle, saddle, tumor height, height of suprasellar and suprasellar tumor, saddle and saddle The lower part of the tumor area, etc., compared with each other and with the degree of gasification and sphenoid sinus resection degree compared. Results There were 29 cases of convex saddle (<90 ° saddle angle), 10 cases of arc type (saddle angle 90 ° ~ 150 °) and 1 case of flat type (saddle angle> 150 °). There was a significant positive correlation between tumor size and saddle length, saddle surface and saddle window (P <0.01). The correlation between tumor size and saddle length was the most significant. The lower part of the saddle tumor height and saddle was positively correlated (P <0.05), both with no correlation between gasification type of sphenoid sinus. Saddle and saddle angle are more independent observations, and the saddle, saddle and saddle length little relationship. Conclusions The larger the pituitary adenoma, sella tendon also tends to increase, especially to make the saddle more protuberant. In the semilunar sphenoid sinus, although the saddle is relatively flat, but because of the larger saddle length and saddle window, open the saddle fenestration operation is not difficult.