Application of CT virtual endoscopy in the surgery of pituitary adenoma / 中国医师进修杂志

ABSTRACT

Objective To explore the clinical efficacy and application value of CT virtual endoscopy (CTVE) in endoscopic resection of pituitary via transsphenoidal approach. Methods From January 2015 to December 2017, 21 patients with pituitary adenomas undergoing endoscopic transsphenoidal approach surgery were selected. All the patients were performed CT scan with GE64 spiral CT before operation, then reconstructed by CTVE. The preoperative CTVE simulated images and the observed images in the operation were compared, and the consistency of the 2 images was analyzed. Results CTVE simulated images and the observed images in the operation showed good consistency in the ratings of sphenoid sinus opening, optic canal protuberance, internal carotid artery protuberance and optic canal internal carotid recess (O-C recess) ( Kappa ＝ 0.774, 0.912, 0.959 and 0.958); and general consistency in the ratings of septum of sphenoid sinus, sellar floor and ramp recess ( Kappa＝0.479, 0.691 and 0.721). Conclusions CTVE technology can accurately simulate the reconstruction of the important anatomical structure of the saddle area before operation, which helps to design the operation plan and improve the curative effect and safety of the operation; this technique also helps to learn and master the endoscope technology.