3D-CTA在颅内肿瘤的应用及手术指导意义

发布时间：2019-05-16 03:31

【摘要】：目的：探讨3D-CTA在颅内肿瘤的应用及对手术方案的指导意义。方法：收集2013年1月—2013年10月术前诊断“颅内肿瘤”并住院经手术治疗和病理证实的患者31例（术前均行磁共振扫描及3D-CTA检查且资料齐全）。其中脑膜瘤：16例；胶质瘤：7例；神经鞘瘤5例；血管母细胞瘤2例；脂肪瘤1例；女性共17例，男性共14例；年龄在33～66岁之间，平均年龄42.6岁。术前经全科医生讨论后根据影像学图像指导手术方案。结果：1、3D-CTA可清楚显示颅内肿瘤的大小及血供情况。2、肿瘤与周围大血管的关系：术前发现肿瘤侵蚀大血管11例，术中见肿瘤与血管粘连严重，部分肿瘤无法与血管分离；术前发现肿瘤推挤大血管20例，术中可将血管从肿瘤上分离。结论：3D-CTA是一种新兴的检查手段，能够清晰、准确地显示肿瘤的立体结构、供血动脉及周围大血管，能为颅内肿瘤的手术治疗提供直观、科学、翔实的影像学资料，指导制定手术方案，，这可使术者在术前判断手术的难度，预测手术风险，预计术中出血情况进行术前备血，减少手术的盲目性，提高手术的安全性。是颅内肿瘤术前评估中非常有价值的影像学检查方法。
[Abstract]:Objective: to investigate the application of 3D-CTA in intracranial tumors and its guiding significance for surgical scheme. Methods: from January 2013 to October 2013, 31 patients with intracranial tumors were diagnosed before operation and confirmed by operation and pathology (MRI and 3D-CTA were performed before operation and with complete data). There were 16 cases of meningioma, 7 cases of glioma, 5 cases of schwannoma, 2 cases of angioblastoma, 1 case of lipoma, 17 cases of female and 14 cases of male, aged between 33 years and 66 years, with an average age of 42.6 years. The surgical plan was guided by imaging images after discussion by the general practitioner before operation. Results: 1, 3D CTA could clearly show the size and blood supply of intracranial tumors. 2, the relationship between tumors and surrounding macrovessels: 11 cases were found to erode macrovessels before operation, and serious adhesion between tumors and blood vessels was found during operation, and some tumors could not be separated from blood vessels. It was found that the tumor pushed and squeezed the large blood vessel in 20 cases before operation, and the blood vessel could be separated from the tumor during operation. Conclusion: 3D-CTA is a new examination method, which can clearly and accurately display the stereoscopic structure of the tumor, the blood supply artery and the surrounding large blood vessels, and can provide intuitive, scientific and detailed imaging data for the surgical treatment of intracranial tumors. Guiding the formulation of surgical plan can make the operator judge the difficulty of operation before operation, predict the risk of operation, predict the bleeding condition before operation, reduce the blindness of operation and improve the safety of operation. It is a very valuable imaging method in preoperative evaluation of intracranial tumors.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.41

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