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目的探讨CT仿真内镜(CT virtual endoscopy,CTVE)对蝶窦中隔的显示情况及其在经蝶手术中的应用价值。方法在119例垂体瘤经蝶手术中,对术前常规垂体CT检查数据进行CTVE及多平面重建(Multiplannar reconstruction,MPR),比较两种方法对蝶窦中隔的显示情况。通过传输函数设计容积重建技术(transferfunction volume rendering,TFVR)透视鞍底,了解蝶窦中隔与鞍底神经、血管的解剖关系。结果CTVE能以三维图像的形式显示蝶窦中隔,在119例蝶窦中共发现蝶窦中隔82.3%(98/119例)、间隔64.7(77/119例)、间嵴115.9%(138/119例),蝶窦中隔以偏向外侧壁为主。通过CTVE的透视功能,可观察到有42.8%(42/98例)中隔附着于颈内动脉的浅面。通过调高观察阈值,可观察到约17.3%(17/98例)中隔附着与视神经管表面。结论CTVE能以三维图像的形式显示蝶窦中隔及其与深部颈内动脉、视神经管的解剖关系。CTVE可用于术前了解蝶窦中隔的解剖关系,指导术中对蝶窦、鞍底及鞍底血管位置的辨认。
Objective To explore the CT virtual endoscopy (CTVentral endoscopy, CTVE) on the sphenoid septum display and its application in transsphenoidal surgery. Methods In 119 cases of pituitary adenoma transsphenoidal surgery, CTVE and MPR were performed on preoperative pituitary CT examination data. The display of the sphenoid sinus septum was compared between the two methods. Through the transfer function design transfer function volume rendering (TFVR) perspective of the saddle, to understand the septum and the sella nerve and blood vessels anatomy. Results CTVE could display the sphenoid sinus septum in the form of three-dimensional image. Sphenoidal septum was found in 119 cases (82.3%) of the sphenoid sinus (98/119 cases), interval was 64.7 (77/119) 119 cases), sphenoid sinus deviated to the lateral wall-based. Through CTVE fluoroscopy, 42.8% (42/98 cases) of septum attached to the superficial part of the internal carotid artery were observed. By raising the observation threshold, about 17.3% (17/98 cases) of septal attachment and optic canal surface were observed. Conclusion CTVE can display the anatomical relationship between the sphenoid sinus septum and its deep internal carotid artery and optic canal in the form of three-dimensional images. CTVE can be used to understand the anatomy of the sphenoid septum before surgery to guide the operation of the sphenoid sinus, saddle at the end of the saddle and the end of the blood vessels to identify.