颅咽管瘤术前影像学特点在预后评估中的作用分析

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目的研究颅咽管瘤(CPs)术前影像学特点在预后评估中的作用。方法回顾性分析87例行开颅手术颅咽管瘤患者的临床资料。采用单因素分析颅咽管瘤术前影像学参数与患者预后的关系；用二元Logistic回归分析颅咽管瘤影像学特点对预后的影响。结果单因素分析显示，肿瘤的大小、形态、质地、钙化程度及侵袭下丘脑程度与预后有显著关系（均P<0.001）。二元Logistic回归分析显示，分叶形肿瘤和实性肿瘤是影响颅咽管瘤患者预后的独立危险因素（OR=22.895，P=0.005；OR=98.639，P=0.016）；而肿瘤大小、钙化程度及侵袭下丘脑程度均不是颅咽管瘤手术预后的独立危险因素。结论颅咽管瘤术前影像学参数中的肿瘤形态、质地可作为手术患者预后评估的独立危险因素，肿瘤大小、钙化程度、侵袭下丘脑程度可作为预后评估的重要参考依据。手术者须根据颅咽管瘤术前影像学特点，评估手术风险，制定合理的手术策略，以期改善患者的预后，为患者带来最大益处。

Abstract: Objective To study the role of preoperative imaging features in the prognosis of craniopharyngiomas(CPs). Methods The clinical data of 87 patients with CPs underwent craniotomy were analyzed retrospectively. The relationship between preoperative imaging parameters and prognosis of CPs was analyzed by univariate analysis. Binary Logistic regression was used to analyze the effect of imaging characteristics of CPs on prognosis. ResultsUnivariate analysis showed that the size, shape, texture, degree of calcification and invasion of hypothalamus were significantly related to the prognosis(all P<0.001). Binary Logistic regression analysis showed that lobular tumor and solid tumor were independent risk factors affecting the prognosis of patients with CPs(OR=22.895,P=0.005;OR=98.639,P=0.016). Tumor size, calcification and invasion of hypothalamus were not independent risk factors for the prognosis of CPs. Conclusions The tumor shape and texture in the preoperative imaging parameters of CPs can be used as independent risk factors for the prognosis evaluation of surgical patients. The tumor size, degree of calcification and degree of invasion of hypothalamus can be used as an important reference basis for the prognosis evaluation. According to the preoperative imaging characteristics of CPs, the operator must evaluate the operation risk and formulate reasonable operation strategies in order to improve the prognosis and bring maximum benefits to the patients.