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背景与目的:脊髓血管网状细胞瘤诊断困难,且手术风险较高,本研究旨在探讨其诊断及显微外科治疗。方法:分析38例患者的MRI表现及其显微外科手术治疗的效果。结果:根据肿瘤在MRI及DSA上的表现可以确诊的病例均行肿瘤显微手术全切除术。术后患者神经系统症状好转者28例,8例无改善,2例加重。结论:MRI能对髓内血管网状细胞瘤作出诊断,而DSA则能帮助了解肿瘤血液供应情况,必要时可在术前先行栓塞,减少术中出血,降低手术风险,减少术后并发症。手术时应在显微镜下严格沿肿瘤界面进行分离,先离断动脉后处理静脉,尽量避免分块切除而力争整块全切,这是减少术中出血和避免神经功能损害的关键,术中电生理监测,对减少术中脊髓、神经损伤非常有帮助。
BACKGROUND & OBJECTIVE: Spinal vascular retinoblastoma is difficult to diagnose and has a high surgical risk. This study aimed to investigate its diagnosis and microsurgical treatment. Methods: The MRI findings of 38 patients and the effect of microsurgical treatment were analyzed. Results: According to the tumor on the MRI and DSA performance can be confirmed cases of tumor microsurgery total resection. Postoperative patients with symptoms of neurological improvement in 28 cases, 8 cases without improvement, 2 cases worse. Conclusion: MRI can diagnose intramedullary vascular reticular neoplasia. DSA can help understand the tumor blood supply. If necessary, embolization can be performed preoperatively to reduce intraoperative bleeding, reduce surgical risk and reduce postoperative complications. Surgery should be strictly under the microscope along the tumor interface separation, the first off the veins after the treatment of veins, try to avoid segmental resection and strive to block the whole cut, which is to reduce intraoperative bleeding and to avoid nerve damage, the key to surgery Physiological monitoring, to reduce intraoperative spinal cord, nerve damage is very helpful.