Anatomic relations of the arachnoidea around the pituitary stalk: relevance for surgical removal of craniopharyngiomas.
Anatomic relations of the arachnoidea around the pituitary stalk: relevance for surgical removal of craniopharyngiomas.
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垂体柄周围蛛网膜的解剖关系：与颅咽管瘤手术切除的相关性
DOI：
10.1007/s00701-010-0940-y
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发表时间：
2011-04
影响因子：
2.4
通讯作者：
Fan, Jun
中科院分区：
文献类型：
--
作者：
Qi, Songtao;Lu, Yuntao;Pan, Jun;Zhang, Xi'an;Long, Hao;Fan, Jun
目的颅咽管瘤（craniopharyngiomas，CP）的生长方式尚不清楚，其形态学特征多样性给临床带来了挑战。这反过来又影响了安全的外科手术策略的发展，这些病变的管理。本研究的目的是提出一个形态学分类的CP的基础上，他们的肿瘤膜的关系。希望这将有助于更好地了解CP形态和预测的术中classification.MethodsHistological技术被用来研究8个胎儿。Masson染色后，显微镜下观察垂体柄周围的膜。195例CP患者术前MRI和术中影像也进行了分析。FindingsThe arachnoidal sleeve around the pituitary stalk（ASPS）被指出是由一个紧凑的纤维成分和相关的松散的小梁组成部分。垂体柄以腹前叶的褶皱为界分为四段。相应地，CP的生长也可分为蛛网膜下（ID）、蛛网膜外（EA）、蛛网膜内（IA）和蛛网膜下（SA）4种基本生长模式。IA生长模式可进一步细分为两个亚型，即IA 1（肿瘤在ASPS的纤维成分内生长）和IA 2（肿瘤在小梁成分内生长）。这种地形分区方法可用于了解CP的生长--红外CP显示生长模式ID或ID与EA一起显示。鞍上CP可表现为脑室外生长型（EA或IA 2）、脑室内外生长型（IA 2 + SA）、漏斗状生长型（ID + IA 1 + SA）和漏斗结节状生长型（SA或SA + IA 1）。儿童和成人的CP生长模式之间存在统计学显著差异。ID增长的优势是在儿童中注意到，而成人往往表现出一种模式，主要是脑室外（EV）growth.ConclusionOur建议的分类详细的周围结构的CP的关系，并声称预测和识别术中解剖分层。它还试图帮助预测这些肿瘤的生长模式。了解肿瘤及其周围关键结构的密切关系可以安全地手术切除。
PurposeThe growth pattern of craniopharyngiomas (CP) is yet to be understood due to challenges arising from the diversity of morphological features that exist. This in turn has had implications on the development of safe surgical strategies for management of these lesions. The aim of this study is to propose a morphological classification of CP based on their tumor–membrane relationship. It is hoped that this will contribute to better understanding of CP morphology and prediction of the intraoperative classification.MethodsHistological techniques were used to study eight fetuses. Following Masson staining, the membranes around the pituitary stalk were observed under microscope. Pre-operative MRI and intraoperative images of 195 patients with CP were also analyzed.FindingsThe arachnoidal sleeve around the pituitary stalk (ASPS) was noted to be comprised of a compact fibrous component and a related loose trabecular component. The pituitary stalk was divided into four segments in accordance with the folds of the ASPS. Correspondingly, the growth of CPs was divided into four basic patterns—infra-diaphragmatic (ID), extra-arachnoidal (EA), intra-arachnoidal (IA) and sub-arachnoidal (SA) growth. The IA growth pattern can be further subdivided into two subtypes—namely, IA1 (with tumor growing within the fibrous component of the ASPS) and IA2 (with tumor growing within the trabecular component). This method of topographical division can be used to understand the growth of CP—infra-diaphragmatic CP show growth pattern ID or ID together with EA. Suprasellar CP can show an extra-ventricular growth pattern (EA or IA2), an extra- and intra-ventricular (IA2 + SA) growth pattern, a trans-infundibular growth pattern (ID + IA1 + SA) and an infundibulo-tuberal growth pattern (SA or SA + IA1). There is a statistically significant difference between CP growth patterns in children and adults. A predominance of ID growth is noted in children while adults tend to show a pattern of predominantly Extra-ventricular (EV) growth.ConclusionOur proposed classification details the relationship of the surrounding structures to CPs and purports to predict and identify the intraoperative anatomical stratification. It also attempts to help predict the growth patterns of these tumors. A knowledge of the intimate relations of the tumor and its key surrounding structures allows for safe surgical removal.
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影响因子：
4.8
作者：
Qi Song-tao;Zhang Xi-an;Lu Yun-tao
通讯作者：
Lu Yun-tao
影响因子：
1.9
作者：
Jane, John A., Jr.;Prevedello, Daniel M.;Laws, Edward R., Jr.
通讯作者：
Laws, Edward R., Jr.
影响因子：
0.7
作者：
HOFFMAN, HJ
通讯作者：
HOFFMAN, HJ
影响因子：
1.9
作者：
Samii, Madjid;Tatagiba, Marcos
通讯作者：
Tatagiba, Marcos
影响因子：
4.8
作者：
Abe, T;Lüdecke, DK
通讯作者：
Lüdecke, DK