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首页> 外文期刊>Neurosurgery >Tumor-third ventricular relationships in supradiaphragmatic craniopharyngiomas: correlation of morphological, magnetic resonance imaging, and operative findings.
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Tumor-third ventricular relationships in supradiaphragmatic craniopharyngiomas: correlation of morphological, magnetic resonance imaging, and operative findings.

机译：radi上颅咽咽喉瘤中的肿瘤与第三脑室的关系：形态学，磁共振成像和手术结果的相关性。

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OBJECTIVE: To disclose the relationships of primarily supradiaphragmatic craniopharyngiomas with the third ventricular floor (3rdVF) by means of preoperative magnetic resonance imaging (MRI) and thus to select the surgical approach avoiding the hypothalamic structures. METHODS: MRI findings in 76 consecutive patients with craniopharyngiomas operated on between June 1991 and December 2002 were interpreted on the basis of the results of the authors' own previous microanatomic studies. The assumed tumor-3rdVF relationships were then correlated with the operative findings. MRI features characteristic for different topographical relationships were analyzed in 44 patients (18 children, 26 adults) with exclusively supradiaphragmatic tumors. RESULTS: In 14 of 15 patients with the tumor located below the 3rdVF (suprasellar extraventricular craniopharyngioma), the anterior communicating artery was displaced upward and indirectly indicated the position of the chiasm between the prechiasmatic and the retrochiasmatic tumor portions. Hydrocephalus was absent in 14 patients, including those with giant tumors. The anterior part of the third ventricular cavity was found in front of the level of the foramina of Monro in 6 patients. All 28 tumors growing partially inside and partially outside the third ventricular cavity (intraventricular and extraventricular craniopharyngioma) were retrochiasmatic. They caused severe or moderate hydrocephalus in 20 patients and mild hydrocephalus in 2. One purely intraventricular tumor caused severe hydrocephalus. CONCLUSION: The position of the optic chiasm and the size of the lateral ventricles on preoperative MRI enable us to determine the position of the 3rdVF or its remnants in relation to the supradiaphragmatic craniopharyngiomas and to select the proper surgical approach allowing exposure of the tumor while avoiding the hypothalamic structures.
机译：目的：通过术前磁共振成像（MRI）揭示主要的radi上性颅咽管神经瘤与第三心室基底层（3rdVF）的关系，从而选择避免下丘脑结构的手术方法。方法：根据作者自己先前的微解剖学研究结果，对1991年6月至2002年12月间连续进行的76例颅咽管瘤患者的MRI检查结果进行了解释。然后将假定的肿瘤3rdVF关系与手术结果相关联。对44例仅具有sup上上tumor肿肿瘤的患者（18名儿童，26名成人）的不同地形关系的MRI特征进行了分析。结果：在15例肿瘤位于3rdVF（上丘脑室上颅咽管瘤）以下的患者中，有14例的前交通动脉向上移位，间接指示了前交叉性和后交叉性肿瘤之间的交叉位置。 14例患者中无脑积水，包括那些患有巨大肿瘤的患者。在6例患者中，在Monro孔的水平前方发现了第三室腔的前部。全部28例肿瘤均在第三心腔内和部分外生长（脑室内和脑室外颅咽管瘤），它们是后气虚的。他们造成20例严重或中度脑积水，2例引起轻度脑积水。一种单纯的脑室内肿瘤引起严重脑积水。结论：术前MRI上视交叉的位置和侧脑室的大小使我们能够确定3rdVF或其残余物相对于ph上颅咽咽喉瘤的位置，并选择合适的手术方法以使肿瘤暴露而避免下丘脑结构。

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