多期CT血管造影在颅底脑膜瘤术前评估中的应用

发布时间：2018-04-21 16:29

本文选题：脑膜瘤 + 体层摄影术　；参考：《中国医学影像学杂志》2017年10期

【摘要】：目的颅底脑膜瘤手术难度大,血管相关并发症凶险。本文探讨多期CT血管造影在颅底脑膜瘤术前评估中的价值,为提高手术安全性提供参考。资料与方法收集2015年1月-2016年12月蚌埠医学院第一附属医院经手术病理证实的颅底脑膜瘤患者46例。所有患者术前均接受多期CT血管造影检查。应用多平面重组、容积再现、多期图像融合等后处理技术,观察肿瘤供血动脉、瘤体与邻近血管的关系,并与术中所见结果比较,评价术前血管造影结果与术中所见结果的一致性。结果 CT血管造影显示,44例可清晰显示肿瘤供血动脉,其中单纯颈外动脉供血15例、颈内外动脉混合供血13例、单纯颈内供血16例,2例显示不清。与术中所见对比,吻合率达84.78%,两者检查结果一致性较好(Kappa=0.78)。46例患者中,血管未受侵36例,血管受侵10例,多期CT血管造影与术中所见对比,吻合率达95.65%,两者检查结果一致性较好(Kappa=0.93);动脉期CT血管造影与术中所见对比,吻合率为67.39%,两者检查结果一致性一般(Kappa=0.45)。结论多期CT血管造影能够清晰地显示颅底脑膜瘤的供血动脉及其与邻近血管的关系,对术前准确评估手术风险、制订手术方案、提高手术安全性具有重要意义。
[Abstract]:Objective the operation of skull base meningioma is difficult and vascular-related complications are dangerous. This paper discusses the value of multiphase CT angiography in preoperative evaluation of meningioma of skull base and provides a reference for improving the safety of operation. Materials and methods 46 patients with meningioma of skull base confirmed by surgery and pathology in the first affiliated Hospital of Bengbu Medical College from January 2015 to December 2016 were collected. All patients underwent multistage CT angiography before operation. The multiplanar reconstruction, volume reconstruction, multiphase image fusion and other post-processing techniques were used to observe the relationship between tumor feeding artery, tumor body and adjacent blood vessels, and the results were compared with the results obtained during the operation. To evaluate the consistency between preoperative angiography and intraoperative findings. Results CT angiography showed that the tumor supplying artery could be clearly displayed in 44 cases, including 15 cases of external carotid artery supply, 13 cases of mixed internal and external carotid artery supply, and 2 cases of unclear internal carotid blood supply. The anastomosis rate was 84.78%. The results of the two examinations were in good agreement. Among the 46 patients, 36 cases had no vascular invasion, 10 cases had vascular invasion, and the results of multiphase CT angiography were compared with those of intraoperative findings. The anastomosis rate was 95.65 and the results of both examinations were in good agreement with that of Kappa-0.93%, and the anastomosis rate of arterial phase CT angiography was 67.39. The consistency between the two examinations was generally 0.45%. Conclusion Multi-phase CT angiography can clearly display the blood supply artery of meningioma of the skull base and its relationship with adjacent vessels. It is of great significance to evaluate the operation risk accurately before operation, to formulate the operation plan and to improve the safety of the operation.
【作者单位】：界首市人民医院影像中心;蚌埠医学院第一附属医院放射科;上海德济医院放射科;
【分类号】：R730.44;R739.45

【相似文献】