经硬膜下入路显微手术切除大型海绵窦血管瘤

发布时间：2018-03-01 10:23

本文关键词： 海绵窦血管瘤影像学表现显微外科手术放疗　出处：《国际神经病学神经外科学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨大型海绵窦血管瘤(cavernous sinus hemangiomas,CSH)的影像学表现及治疗方式。方法对经手术术后病理证实的4例大型CSH的影像学及临床资料进行回顾性分析,并复习相关文献。4例患者均做头颅MRI、头颅CTA扫描,后经硬膜下入路行显微外科手术治疗。结果病变在头颅MRI上呈等T1、边缘锐利的短T2表现、FLAIR高信号,增强后快速均匀强化或延迟欠均匀强化(最终达到均匀强化),肿瘤不同程度向中颅窝、鞍区、鞍上生长;头颅CTA显示肿瘤无明显供血动脉,但周边细小血管丰富;4例患者均只做到部分切除。术中平均失血3425 ml,术后3例出现颅神经功能障碍。结论根据头颅MRI特征性表现基本能诊断CSH,相比显微手术潜在的风险,射波刀放疗效果显著,可能会逐步成为本病的首选治疗方式。
[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.
【作者单位】：昆明医科大学第一附属医院神经外二科;
【基金】：国家自然科学基金(81560206)
【分类号】：R739.4

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