论文部分内容阅读
目的探讨内侧型蝶骨嵴脑膜瘤分型及治疗方法,改善该类患者的治疗效果。方法对29例患者的影像学资料、治疗方法和结果进行回顾性分析。结果根据MR I所见肿瘤主体部位分为I型(颅前窝型)9例,全切率100%;II型(颅中窝型)16例手术治疗15例,全切10例,次全切4例,大部切除1例;III型(混合型)4例,次全切3例,大部切除1例;术后视力改善12例,无变化2例,视力恶化1例,一过性偏瘫6例,一过性动眼神经麻痹2例,死亡1例;1例II型患者拒绝手术行X-刀治疗,放疗后3个月因脑水肿脑疝行减压术,半年复查MR I可见肿瘤体积缩小,肿瘤中心坏死;未能全切患者均行放疗,8例得以随访3个月~5年未见肿瘤增大。结论在患者安全的前提下尽量全切肿瘤应为首选的治疗方法,颅前窝为主的肿瘤全切率极高,颅中窝型和混合型全切率较低;对残余肿瘤应行放疗,在术后2个月左右脑水肿消退后行立体定向放疗可减少放疗引起的脑损伤,减少肿瘤复发机会。
Objective To investigate the classification and treatment of medial sphenoid ridge meningioma and to improve the therapeutic effect of these patients. Methods 29 cases of patients with imaging data, treatment methods and results were retrospectively analyzed. According to the results of MR I, there were 9 cases with type I (anterior cranial fossa) and 100% with full resection (type II) 4 cases of resection, 1 case of most resection; 4 cases of type III (mixed type), 3 cases of subtotal resection and 1 case of most resection; 12 cases of postoperative visual acuity improvement, 2 cases of no change, 1 case of visual acuity deterioration, 6 cases of sexual hemiplegia, transient oculomotor nerve paralysis in 2 cases, 1 case of death; 1 case of type II patients refused surgery X-knife treatment, 3 months after radiotherapy due to cerebral edema brain hernia decompression, 6 months review MR I visible reduced tumor size, tumor center necrosis; failed to fully resect patients were treated with radiotherapy, 8 cases were followed up for 3 months to 5 years no tumor increased. Conclusion Totally resection of the tumor should be the first choice of treatment under the premise of patient safety. The total resection rate of the tumor in the anterior cranial fossa is very high, and the rate of complete resection of the middle cranial fossa type and mixed type is lower. The residual tumor should be treated with radiotherapy , Stereotactic radiotherapy after brain edema subsided about 2 months after surgery can reduce brain damage caused by radiotherapy and reduce the chance of tumor recurrence.