Diagnostic Value of Non-Contrast CT in Cerebrospinal Fluid Leakage After Endoscopic Transnasal Surgery for Sellar and Suprasellar Tumors.
Diagnostic Value of Non-Contrast CT in Cerebrospinal Fluid Leakage After Endoscopic Transnasal Surgery for Sellar and Suprasellar Tumors.
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平扫CT对经鼻内镜鞍及鞍上肿瘤术后脑脊液漏的诊断价值
DOI：
10.3389/fonc.2021.735778
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发表时间：
2021
影响因子：
4.7
通讯作者：
Li C
中科院分区：
文献类型：
--
作者：
Gao W;Wang X;Fang Y;Hong Y;Yan W;Zhang S;Li C
我们的目的是研究鼻内镜下经蝶鞍和鞍上肿瘤手术后，非增强CT（NCCT）显示的颅内积气与术后脑脊液漏（p-CFL）之间的关系。连续收集并审查了2018年1月至2020年3月接受鞍区或鞍上肿瘤内镜治疗的患者的数据。分别于术后第1天和取出膨胀海绵后第1天测量NCCT颅内积气（NP）。根据术后临床症状、高分辨率CT和血糖检查以及专家共识确定p-CFL。在入组本研究的253例患者中，32例（12.6%）患有p-CFL。与无p-CFL的患者相比，p-CFL患者术中CFL的发生率更高，手术时间更长，术后第一天NCCT时气颅的发生率更高（即，第一天NP），以及两次NCCT测量之间较高的NP体积变化率（称为NP变化）（所有p < 0.05）。在多变量回归分析中，第一天NP与p-CFL发生独立相关[比值比（OR）=6.395，95%置信区间（CI）=2.236-18.290，p=0.001）。将NP变化加入回归模型后，第一天的NP不再与p-CFL独立相关，NP变化（OR = 19.457，95%CI = 6.095-62.107，p<0.001）与p-CFL独立相关。受试者工作特征曲线比较分析显示，NP变化的预测值显著优于第一天NP（曲线下面积：0.988 vs. 0.642，Z=6.451，p=0.001）。NP是预测内镜下鞍区及鞍上肿瘤术后p-CFL的有效影像学指标，NP变化具有较好的预测价值。
We aimed to study the relationship between pneumocephalus on non-contrast CT (NCCT) and post-operative cerebrospinal fluid leakage (p-CFL) after endoscopic transsphenoidal sellar and suprasellar tumor surgeries. Data from patients who underwent endoscopic treatment for sellar or suprasellar tumors from January 2018 to March 2020 were consecutively collected and reviewed. The NCCT pneumocephalus (NP) was measured the first day after operation and the first day after the expansive sponge was extracted. p-CFL was determined according to post-operative clinical symptoms, high resolution CT and glucose test, and expert consensus. Of the 253 patients enrolled in this study, 32 (12.6%) had p-CFL. Compared with patients without p-CFL, patients with p-CFL had a higher occurrence of intra-operative CFL, a longer operation time, a higher rate of pneumocephalus on first-day NCCT after operation (i.e., first-day NP), and a higher rate of NP volume change between two NCCT measurements (referred to as the NP change) (all p < 0.05). In multivariate regression analysis, first-day NP was independently associated with p-CFL occurrence [odds ratio (OR)=6.395, 95% confidence interval (CI)=2.236-18.290, p=0.001). After adding the NP change into the regression model, first-day NP was no longer independently associated with p-CFL, and NP change (OR = 19.457, 95% CI = 6.095–62.107, p<0.001) was independently associated with p-CFL. The receiver operating characteristic curve comparison analysis showed that NP change had a significantly better predicting value than first-day NP (area under the curve: 0.988 vs. 0.642, Z=6.451, p=0.001). NP is an effective imaging marker for predicting p-CFL after endoscopic sellar and suprasellar tumors operation, and the NP change has a better predicting value.
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影响因子：
4.1
作者：
Guo, Kang;Heng, Lijun;Jia, Dong
通讯作者：
Jia, Dong
影响因子：
3.4
作者：
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影响因子：
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作者：
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ALBIN, MS
DOI：
10.1007/s12070-018-1485-2
发表时间：
2019-03-01
影响因子：
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作者：
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通讯作者：
Sharma, Akriti
影响因子：
1.3
作者：
Ozturk, E.;Kantarci, M.;Kizilkaya, E.
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Kizilkaya, E.