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目的分析脑膜瘤的CT及MRI特征,评估CT及MRI在脑膜瘤术前定位、定性诊断及制定手术方案中的价值。方法回顾性分析经手术病理证实的27例脑膜瘤患者的CT及MRI资料,并与手术及术后病理结果对照。结果 27例脑膜瘤患者,MSCT平扫诊断率70.37%,MSCTA清晰显示肿瘤相邻的动脉与骨性解剖标志之间的三维关系;MRI平扫27例定位为颅内脑实质外肿瘤;MRI增强扫描诊断率96.30%,其中15例静脉窦旁脑膜瘤清晰显示肿瘤与静脉窦的相邻关系及静脉窦受压闭塞程度。依据MRI增强扫描及MSCTA定位诊断结果制定手术入路及方式,其中1例鞍旁脑膜瘤包绕颈内动脉虹吸部,另1例视神经管区域脑膜瘤包埋视神经部分予以残留;2例与矢状窦关系密切行脑膜瘤大部切除;余23例脑膜瘤完全切除。术后均无明确偏瘫、失明、失语等神经系统医源性损害症状。术后观察或随访1~24个月,无死亡病例。结论CT及MRI在脑膜瘤诊断、评估手术入路、保护肿瘤相邻动脉及静脉窦、减少医源性神经功能损害方面有重要价值。
Objective To analyze the CT and MRI features of meningiomas and evaluate the value of CT and MRI in the preoperative localization, qualitative diagnosis and surgical planning of meningioma. Methods The CT and MRI data of 27 cases of meningioma confirmed by surgery and pathology were retrospectively analyzed. The results were compared with the surgical and postoperative pathological findings. Results In 27 cases of meningiomas, the diagnostic accuracy of MSCT was 70.37%. MSCTA clearly showed the three-dimensional relationship between adjacent arteries and the anatomical landmarks of the tumors. The MRI scan of 27 cases was located in the extracranial intracranial brain tumors. MRI enhanced Scanning diagnosis rate of 96.30%, of which 15 cases of paraventricular septum meningioma clearly shows the tumor and sinus adjacent relationship and occlusion of venous pressure. According to the results of MRI enhanced scan and MSCTA, the surgical approaches and methods were established. Among them, 1 was the parasellar meningioma surrounding the siphon portion of the internal carotid artery and 1 was the residual optic nerve segment of the meningioma in the optic canal region. Most of the meningeal tumors resected were closely related to the sinusoids. The remaining 23 cases were completely resected. No postoperative hemiplegia, blindness, aphasia and other nervous system iatrogenic symptoms. Postoperative observation or follow-up of 1 to 24 months, no deaths. Conclusion CT and MRI have important value in the diagnosis of meningiomas, the evaluation of surgical approach, the protection of adjacent arteries and sinuses and the reduction of iatrogenic nerve damage.