颅内表皮样囊肿的影像学特点与显微手术治疗

发布时间：2018-05-09 00:21

本文选题：表皮样囊肿 + 影像学特点　；参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：探讨颅内表皮样囊肿的影像学特点和桥小脑角区表皮样囊肿手术方法优劣。方法：回顾性分析了2012年3月-2014年1月我科收治的颅内表皮样囊肿21例的临床资料,21例患者(包括15例桥小脑角区表皮样囊肿患者)均采用单纯显微镜下手术治疗；回顾文献,2007年1月-2009年12月我科收治的桥小脑角区表皮样囊肿10例均采用神经内镜辅助显微手术治疗。比较两组桥小脑角区表皮样囊肿患者手术治疗效果。结果：21例表皮样囊肿在影像学上呈典型表现17例(77.3%),非典型表现4例(22.7%)；病变位于桥小脑角15例,中颅窝底1例,位于右侧颞叶、小脑蚓部、左侧额颞叶、左侧眼眶内、第四脑室各1例；肿瘤全切17例(81.0%),次全切4例(19.0%),死亡1例；出现术后并发症：无菌性脑膜炎1例,面瘫4例。术后随访3月-1年,4例面瘫患者症状有所改善,无复发病例。两组桥小脑角表皮样囊肿患者手术全切率无差别(P=0.6260.05),术后新发面神经功能障碍率无差别(P0.05)。结论：绝大部分表皮样囊肿在CT上呈低密度,MRI上呈长T1WI长T2WI信号,在DWI上呈明显高信号,增强扫描后不强化,其表现特异,诊断明确；对于非常见部位表皮样囊肿在影像学上表现不典型者明确诊断较为困难,其性质往往需术中所见或术后病理证实。神经内镜辅助显微手术治疗扩大了手术视野,消除了手术盲区,提高了手术全切率的认识,在手术操作中并不影响面神经功能。
[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.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.4

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