經(jīng)硬膜下入路顯微手術(shù)切除大型海綿竇血管瘤
本文關(guān)鍵詞: 海綿竇血管瘤 影像學表現(xiàn) 顯微外科手術(shù) 放療 出處:《國際神經(jīng)病學神經(jīng)外科學雜志》2017年02期 論文類型:期刊論文
【摘要】:目的探討大型海綿竇血管瘤(cavernous sinus hemangiomas,CSH)的影像學表現(xiàn)及治療方式。方法對經(jīng)手術(shù)術(shù)后病理證實的4例大型CSH的影像學及臨床資料進行回顧性分析,并復習相關(guān)文獻。4例患者均做頭顱MRI、頭顱CTA掃描,后經(jīng)硬膜下入路行顯微外科手術(shù)治療。結(jié)果病變在頭顱MRI上呈等T1、邊緣銳利的短T2表現(xiàn)、FLAIR高信號,增強后快速均勻強化或延遲欠均勻強化(最終達到均勻強化),腫瘤不同程度向中顱窩、鞍區(qū)、鞍上生長;頭顱CTA顯示腫瘤無明顯供血動脈,但周邊細小血管豐富;4例患者均只做到部分切除。術(shù)中平均失血3425 ml,術(shù)后3例出現(xiàn)顱神經(jīng)功能障礙。結(jié)論根據(jù)頭顱MRI特征性表現(xiàn)基本能診斷CSH,相比顯微手術(shù)潛在的風險,射波刀放療效果顯著,可能會逐步成為本病的首選治療方式。
[Abstract]:Objective to investigate the imaging features and treatment of cavernous sinus hemangiomatous hemangioma of large cavernous sinus hemangioma. Methods the imaging and clinical data of 4 cases of large CSH proved by operation and pathology were retrospectively analyzed. All the patients underwent cranial MRI, cranial CTA scanning, and posterior subdural approach for microsurgical treatment. Results the lesion presented as iso-T _ 1 on cranial MRI and sharp margin on short T2 with flair high signal intensity. After enhancement, rapid homogeneous enhancement or delayed hypohomogeneous enhancement (eventually homogeneous enhancement was achieved, the tumor grew to the middle cranial fossa, Sellar region and suprasellar region in varying degrees, and the cranial CTA showed that there was no obvious blood supply artery in the tumor. The mean blood loss was 3425ml during the operation, and the cranial nerve dysfunction occurred in 3 patients after the operation. Conclusion according to the characteristic features of cranial MRI, it is possible to diagnose CSHs, and the potential risk of microsurgery is higher than that of microsurgery. The radiotherapeutic effect of wave knife is remarkable and may gradually become the first choice for the treatment of this disease.
【作者單位】: 昆明醫(yī)科大學第一附屬醫(yī)院神經(jīng)外二科;
【基金】:國家自然科學基金(81560206)
【分類號】:R739.4
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