目的 探讨术前MRI影像对内镜下 经鼻蝶垂体瘤切除术中垂体功能保护的 价值。方法 回顾性分析医院择期内镜下 经鼻蝶垂体瘤切除术的垂体瘤患者34例临 床资料，手术前后均行MRI检查。结果 本 组46例患者中，82.61%行肿瘤全切。术前 MRI表现为肿瘤呈类圆形、分叶状、不规 则形等；垂体大腺瘤MRI表现为，T1WI等 信号，T2WI高信号，增强扫描大部分有不 同程度的强化；垂体微腺瘤为TI略低信号 或等信号，T2等信号或高信号，增强扫描 显示为低信号。质软以高信号为主，质中 和质硬以低信号为主，增强扫描显示明显 强化。术后MRI显示瘤影消失，鞍区内容 物明显消失，高信号明显减少。术前和 术后7天GH、TSH、FSH、LH水平无显著变 化，不具统计学意义(P＞0.05)。结论 术 前MRI影像对内镜下经鼻蝶垂体瘤切除术 有一定指导意义，且可减少对垂体功能的 损伤。

Objective To investigate the value of preoperative MRI imaging in the protection of pituitary function in endoscopic trans-sphenoidal pituitary adenoma resection. Methods The clinical data of 34 patients with pituitary adenoma who underwent elective endoscopic trans-sphenoidal pituitary adenoma resection were retrospectively analyzed. MRI examination was performed before and after surgery. Results In this group of 46 patients, 82.61% underwent total adenoma resection. Preoperative MRI showed that the adenomas were quasi-circular, lobulated and irregular, etc. MRI findings of pituitary macroadenoma showed equal signal on T1WI and high signal on T2WI and most of them had different degrees of enhancement; Pituitary microadenoma showed slightly low signal or equal signal on TI, equal signal or high signal on T2 and enhanced scan showed low signal. Soft matter mainly showed high signal and central and hard matter mainly showed low signal. Enhanced scan showed obvious enhancement. Postoperative MRI showed that the adenoma shadow disappeared, the contents of the saddle region significantly disappeared and high signals decreased significantly. 7d before and after operation, there were no significant changes in levels of GH, TSH, FSH and LH, without statistical significance (P＞0.05). Conclusion Preoperative MRI imaging has certain guiding significance in endoscopic trans-sphenoidal pituitary adenoma resection and can reduce the damage to the pituitary function.