本文選題：表皮樣囊腫 + 影像學特點��； 參考：《新疆醫(yī)科大學》2014年碩士論文

【摘要】：目的：探討顱內(nèi)表皮樣囊腫的影像學特點和橋小腦角區(qū)表皮樣囊腫手術方法優(yōu)劣。方法：回顧性分析了2012年3月-2014年1月我科收治的顱內(nèi)表皮樣囊腫21例的臨床資料,21例患者(包括15例橋小腦角區(qū)表皮樣囊腫患者)均采用單純顯微鏡下手術治療；回顧文獻,2007年1月-2009年12月我科收治的橋小腦角區(qū)表皮樣囊腫10例均采用神經(jīng)內(nèi)鏡輔助顯微手術治療。比較兩組橋小腦角區(qū)表皮樣囊腫患者手術治療效果。結果：21例表皮樣囊腫在影像學上呈典型表現(xiàn)17例(77.3%),非典型表現(xiàn)4例(22.7%)；病變位于橋小腦角15例,中顱窩底1例,位于右側(cè)顳葉、小腦蚓部、左側(cè)額顳葉、左側(cè)眼眶內(nèi)、第四腦室各1例；腫瘤全切17例(81.0%),次全切4例(19.0%),死亡1例；出現(xiàn)術后并發(fā)癥：無菌性腦膜炎1例,面癱4例。術后隨訪3月-1年,4例面癱患者癥狀有所改善,無復發(fā)病例。兩組橋小腦角表皮樣囊腫患者手術全切率無差別(P=0.6260.05),術后新發(fā)面神經(jīng)功能障礙率無差別(P0.05)。結論：絕大部分表皮樣囊腫在CT上呈低密度,MRI上呈長T1WI長T2WI信號,在DWI上呈明顯高信號,增強掃描后不強化,其表現(xiàn)特異,診斷明確；對于非常見部位表皮樣囊腫在影像學上表現(xiàn)不典型者明確診斷較為困難,其性質(zhì)往往需術中所見或術后病理證實。神經(jīng)內(nèi)鏡輔助顯微手術治療擴大了手術視野,消除了手術盲區(qū),提高了手術全切率的認識,在手術操作中并不影響面神經(jīng)功能。
[Abstract]:Objective: to investigate the imaging features of intracranial epidermoid cysts and the surgical methods of cerebellopontine angle region epidermoid cysts. Methods: the clinical data of 21 cases of intracranial epidermoid cysts (including 15 cases of epidermoid cysts in cerebellopontine angle region) were analyzed retrospectively from March 2012 to January 2014. From January 2007 to December 2009, 10 cases of epidermoid cysts in cerebellopontine angle region were treated with endoscope-assisted microsurgery. To compare the results of surgical treatment of epidermoid cysts in cerebellopontine angle region between the two groups. Results in 21 cases of epidermoid cysts, 17 cases presented typical imaging findings and 4 cases had atypical manifestations. The lesions were located in the cerebellopontine angle in 15 cases, in the middle fossa in 1 case, in the right temporal lobe, in the vermis of the cerebellum, in the left frontotemporal lobe and in the left orbit. There were 1 case in the fourth ventricle, 1 case in the fourth ventricle, 17 cases in the total resection of tumor, and 4 cases in the subtotal resection. The postoperative complications were aseptic meningitis in 1 case, facial palsy in 4 cases. Four patients with facial paralysis were followed up for 3 months to 1 year. There was no difference in the total removal rate of P0. 6260. 05 in the patients with epidermoid cysts of cerebellopontine angle, and there was no difference in the rate of new facial nerve dysfunction after operation (P 0. 05). Conclusion: most epidermoid cysts show long T1WI long T2WI signal on CT and high signal on DWI. The diagnosis of epidermoid cysts is difficult to diagnose, and its nature often needs to be proved by intraoperative or postoperative pathology. Endoscope-assisted microsurgery has enlarged the operation visual field, eliminated the blind area of the operation, improved the understanding of the total operation rate, and did not affect the facial nerve function in the operation.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R739.4

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