| Objective:With PVEP examination as the guidance,comparing study of visual pathways'lesion caused by pituitary adenoma from preoperation to postoperation by DTI,discussing whether the acquired decline interval of preoperative visual radiation's FA value of the postoperative visual improved patients can evaluate the patients9 prognosis and outcome and provide guidance for clinical work.Using DTI to Monitor the changes in the value of FA of bilateral visual radiation in patients with pituitary adenoma before and after operation at different periods,combined with preoperative and postoperative PVEP examination to determine the patients with improved visual function after surgery,and then to obtain such patients'roughly decline interval of FA value of bilateral visual radiation before surgery compared to normal person.Using this interval to assess the prognosis of patients and guide clinical work.Methods:A total of 30 patients with pituitary adenoma who received by the fourth affiliated hospital of Kunming Medical University from March 2015 to September 2016 were examined with PVEP and DTI before operation?1 week after operation?3 months after operation.Using PVEP as the standard,judging whether the vision condition of the patients has been improved or not 1 week and 3 months after surgery,and analyzing the correlation between DTI parameters and PVEP parameters.Determining the postoperative visual improvement group,reviewing these patients'bilateral visual radiations' FA value before surgery and establishing the postoperative visual improved group's preoperative group.comparing the difference between the postoperative visual improved group's preoperative group and the control group and establishing the visual improvement decline interval of FA value of bilateral visual radiation.Results:PVEP examination showed that:1 week after surgery the vision improved a total of 0 cases,3 months after surgery the vision improved a total of 18 cases.(1)There was no statistical significant difference in bilateral eyes P100 wave amplitude value between the preoperative patient group and the one week postoperatively;(2)There was no statistical significant difference in FA value of bilateral visual radiation between preoperative patient group and 1 week postoperatively group;(3)And there was a significant positive correlation between the bilateral eyes P100 wave amplitude value and the FA value of bilateral visual radiation of Preoperative patient group and 1 week postoperatively group(R = 0.984,0.880,0.869,0.860,P<0.01);(4)There was significant difference in bilateral eyes P100 wave amplitude value between the postoperative visual improved group's preoperative group and postoperative visual improved group 3 months after operation(P<0.01);(5)There was significant difference in the FA value of bilateral visual radiation between the postoperative visual improved group's preoperative group and postoperative visual improved group 3 months after operation(P<0.01);(6)There was significant positive correlation in the bilateral eyes P100 wave amplitude value and the FA value of bilateral visual radiation between the postoperative visual improved group's preoperative group and postoperative visual improved group 3 months after operation(r = 0.839,0.923,0.905,0.901,P<0.01);(7)There was significant difference in the FA value of bilateral visual radiation between the postoperative visual improved group's preoperative group and the control group(P<0.01);Compared with the control group,the FA value of bilateral visual radiation decreased by about 0.087 ± 0.014 ×1O-3mm2/s.Conclusion:(1)Pituitary adenoma patients about 1 week after surgery,patients' visual has no significant improvement,clinical evaluation of pituitary adenoma surgery effection and prognosis situation has no obvious significance during this period;(2)pituitary adenoma patients about 3 months after surgery,patients' visual significantly improved,clinical evaluation of pituitary adenoma surgery effection and prognosis situation can be done during this period;(3)The eye PVEP examination and the bilateral visual radiation DTI examination of the patients with pituitary adenoma showed a high positive correlation between the visual conduction path damage degree and the degree of recovery.Therefore,the change of the FA value of the DTI examination parameters could be an effective means used to evaluate the pituitary adenoma's degree of visual pathway's injury and assess the effect of surgical treatment;(4)The decrease of FA value in patients with pituitary adenoma before surgery was significantly correlated with the surgical treatment effect and prognosis.The degree of FA value before surgery decreased by?(0.087 ± 0.014)×10-3mm2/s prompted patients with good prognosis,visual function will have varying degrees of improvement. |
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