| Objective: Pituitary tumor is a kind of neuroendocrine tumor,accounting for about 10-15% of central nervous system tumors.With the development of neuroendoscopy,transsphenoidal neuroendoscopic surgery has became the most important treatment of pituitary tumors.The effect of operation and the choice of surgical methods depend on the size of the tumor,the direction of invasion and the texture of the tumor.Among them,the preoperative prediction of tumor texture still has great difficulties,but it has important implications for the surgical treatment of pituitary tumors.By segment the image and reconstruct the model of magnetic resonance images of pituitary tumors,the relationship between the proportion of volume and surface area of each part and the texture of pituitary tumor was analyzed,and the application effect of magnetic resonance three-dimensional reconstruction in the preoperative evaluation of pituitary tumor texture was discussed.Methods : In this study,70 patients with pituitary tumors who had underwent neurosurgery operation in the First Affiliated Hospital of China Medical University from January 2015 to July 2018 were selected.The postoperative pathological diagnosis confirmed that all the patients included in the study were pituitary tumor patients.According to the intraoperative findings,all cases were divided into three groups: soft texture,medium texture and tough texture.The clinical data,MRI images and surgical status of the patients were collected,and the relationship between different surgical methods and postoperative complications was discussed.The Mimics software was used to reconstruct the enhanced magnetic resonance images of each patient,and the images were divided into three parts according to the intensity of the enhancement effect.The volume,surface area and the ratio were calculated,and the relationship between the proportions and tumor texture were analyzed.Results:1.The incidence of fever,ion disorder and pituitary hypofunction after single nostril surgery is lower than that of double nostril surgery,but the incidence of postoperative diabetes insipidus is higher.2.The pituitary tumor reconstruction model has a clear outline and a complete structure,which can accurately reflect the actual structure of the tumor.3.The calculated average threshold can accurately segment the images.There is no significant difference between the images with average threshold segmentation and the images obtained by manual segmentation(P>0.05).4.According to the tumor texture,the differences between the groups were compared.It was found that there were significant differences between groups(P<0.01).According to the ordered logistic regression analysis,the ratio of the hardness of the pituitary tumor to the volume of the enhanced enhancement scan and the ratio of the surface area of the moderately enhanced part to the total surface area were positively correlated(P<0.05).Conclusion:1.The soft texture of the tumor should be considered as one of the considerations for the choice of surgical methods for pituitary tumors.Correct selection of surgical methods can reduce the occurrence of postoperative complications.2.By using Mimics software,accurate image segmentation and 3D reconstruction of pituitary tumor magnetic resonance images can be realized,and the visualization of pituitary tumors can be realized.3.The proportion of volume and surface area of each part is significantly different between different texture groups.4.The proportion of the apparently enhanced part of the volume of the tumor as a whole is related to the texture of the pituitary tumor.The higher the proportion,the tougher the texture of the pituitary tumor.5.The ratio of the surface area of the moderately enhanced part to the overall surface area of the tumor is related to the texture of the pituitary tumor.The higher the proportion,the tougher the texture of the pituitary tumor.5.The predictive model established in this study can help clinicians select the tumor texture. |
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