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目的:探讨脊髓海绵状血管瘤的诊治方法和特点。方法:1991~2001年治疗脊髓海绵状血管瘤22例,均进行MRI检查,16例行全脊髓血管造影。全组均经后背正中直切口显微手术治疗。结果:22例均为单发,1例术前未能明确诊断,术后证实为海绵状血管瘤。颈段8例,颈胸段6例,胸段4例,腰段2例,圆锥马尾部位2例。MRI显示团块状短T1长T2信号,中间由点条状长T1短T2信号分隔,形成桑葚状混杂信号团,周边绕以低信号团,尤以T2WI显著。随访3个月~2年,全组均未见复发,12例术后功能明显恢复。结论:MRI是脊髓海绵状血管瘤术前最可靠的诊断方法。全脊髓血管造影可以排除其它脊髓血管畸形。显微手术切除是脊髓海绵状血管瘤的优选治疗方法,术中精细的显微操作是手术成功的关键。
Objective: To investigate the diagnosis and treatment of spinal cavernous hemangiomas and their characteristics. Methods: From 1991 to 2001, 22 cases of spinal cavernous hemangiomas were treated with MRI and 16 cases with all-spider angiography. The whole group were straight back straight incision microsurgical treatment. Results: All of the 22 cases were single, one case had not been diagnosed preoperatively, and cavernous hemangioma was confirmed after operation. 8 cases of cervical segment, 6 cases of cervical thoracic segment, 4 cases of thoracic segment, 2 cases of lumbar segment, 2 cases of cauda equina cauda equina. MRI showed a short T1 long T2 signal of bulk, separated by a long T1 short T2 signal in the middle, formed mulberry mixed signal group, around the surrounding low signal group, especially T2WI significant. All the patients were followed up for 3 months to 2 years. No recurrence was found in the whole group, and postoperative function of 12 patients recovered obviously. Conclusion: MRI is the most reliable diagnostic method for preoperative cavernous hemangiomas in the spinal cord. Full spinal angiography can exclude other spinal vascular malformations. Microsurgical resection is the preferred treatment for cavernous hemangiomas of the spinal cord. Fine intraoperative microsurgery is the key to successful operation.