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术前鉴别向鞍上扩展的无分泌功能的垂体巨大腺瘤与鞍隔脑膜瘤有一定难度,然而,对制定手术计划非常有用。大部分鞍内和鞍上巨大腺瘤经由蝶窦路径,而鞍隔脑膜瘤需要开颅术。作者回顾分析了5例术前误诊为巨大腺瘤并经蝶窦手术的鞍隔脑膜瘤MRI特点。500例经蝶窦手术病例中,110例术前诊断为五分泌功能垂体巨大腺瘤,其中5例术中和组织学检查表现为典型脑膜瘤,需要第二次经颞骨开颅术。女4例,男1例。均有视力障碍:2例双颞侧偏盲,2例单侧视力丧失,1例单颞侧偏盲。1例轻度高泌乳素血症。1例中度甲状腺功能低下。
Preoperative identification of the expansion of the saddle to the non-secreting pituitary gland adenoma and septum meningioma with some difficulty, however, to develop a surgical plan is very useful. Most of the saddle and suprasellar giant adenoma via the sphenoid sinus path, and septum meningioma need craniotomy. The authors retrospectively analyzed MRI features of 5 cases of septal meningiomas, which were misdiagnosed as giant adenomas and trans-sphenoid sinus surgery. Of the 500 cases of transsphenoidal surgery, 110 had preoperative diagnosis of five-pituitary giant pituitary adenomas, of which 5 were intracranial and histological examination of typical meningiomas, requiring a second temporal craniotomy. 4 females, 1 males. All had visual impairment: 2 cases of bilateral temporal hemianopsia, 2 cases of unilateral visual loss, 1 case of single temporal hemianopsia. 1 case of mild hyperprolactinemia. 1 case of moderate hypothyroidism.