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目的 探讨蝶骨嵴脑膜瘤血液供应的特点及其术前栓塞对手术切除的意义。方法5 2例蝶骨嵴脑膜瘤患者中 ,发生于右侧者 31例 ,左侧者 2 1例 ;5 2例患者全部行DSA造影 ,30例患者行颈外系统供血动脉栓塞治疗 ,栓塞治疗后 5～ 7d行手术切除。结果 (1)脑膜瘤的占位改变可导致邻近周围脑血管的异常改变。 (2 ) 5 2例患者中 ,单纯由颈外动脉系统分支供血的有 11例 ,颈外动脉分支和颈内动脉分支双重供血的 2 9例 ,单纯由颈内动脉系统供血的 12例。 (3) 30例行肿瘤供血动脉栓塞的患者中 ,2 5例采用明胶海绵颗粒栓塞 ,5例采用丝线栓塞。栓塞的颈外供血动脉主要为 :脑膜中动脉 18例 ,脑膜中动脉与脑膜副动脉同时被栓塞者 10例。栓塞后肿瘤染色明显减轻者 2 0例 ,染色消失者 5例 ,肿瘤染色减轻不明显者 5例。 (4 )栓塞后行手术切除的 30例患者中 ,2 4例被完整切除 ,而未行栓塞的 2 2例患者中 ,仅 10例被全切除 ,二者统计学上差异具有显著性意义 (χ2 =3.86 ,P <0 .0 5 )。结论 蝶骨嵴脑膜瘤的术前造影和栓塞有利于肿瘤的完整切除。
Objective To investigate the characteristics of sphenoid ridge meningioma blood supply and the significance of preoperative embolization for surgical resection. Methods Fifty-two cases of sphenoid ridge meningioma occurred on the right side in 31 cases and on the left side in 21 cases. All 52 patients underwent DSA angiography, 30 cases underwent external carotid artery embolization and embolization After 5 ~ 7d surgical resection. Results (1) The change of the occupying position of meningioma can lead to abnormal changes of adjacent peripheral blood vessels. (2) Among 52 patients, there were 11 cases in which the external carotid artery branches were supplied with pure blood, 29 cases with double supply of external carotid artery branches and internal carotid artery branches, and 12 cases with purely internal carotid artery supply. (3) Twenty-five patients with embolization of tumor-supplying artery were treated with gelatin sponge embolization, and 5 patients were treated with thread embolization. Embolization of the external carotid artery mainly as follows: 18 cases of middle meningeal artery, middle meningeal artery and meningeal artery simultaneously embolized in 10 cases. Embolism after staining significantly reduce those 20 cases, 5 cases of disappearance of staining, tumor staining in 5 cases were not obvious. (4) Of the 30 patients who underwent surgical resection after embolization, 24 patients were completely resected, but of the 22 patients who did not undergo embolization, only 10 patients underwent total resection, and the difference was statistically significant ( χ2 = 3.86, P <0.05). Conclusion Sphenoid ridge meningioma preoperative angiography and embolization is conducive to the complete removal of the tumor.