颅后窝实质性血管母细胞瘤手术前血管内栓塞治疗  

Preoperative Endovascular Embolization of Solid Hemangioblastoma of Posterior Cranial Fossa

作　　者：王巍[1] 张晓龙[1] 冷冰[1] 宋冬雷[1] 黄祥龙[1] 冯晓源[1] 

机构地区：[1]复旦大学附属华山医院放射科,200040

出　　处：《中国医学计算机成像杂志》2004年第3期201-205,共5页Chinese Computed Medical Imaging

摘　　要：目的探讨术前血管内栓塞治疗对血管母细胞瘤手术切除的价值。材料和方法16例经CT、MRI及DSA检查诊断为血管母细胞瘤患者(9例病变位于小脑半球,3例位于小脑蚓部,2例位于延髓,1例位于第四脑室,1例位于左侧CP角)手术切除前均在局麻下经微导管行供血动脉PVA颗粒栓塞。栓塞后1周内行手术切除肿瘤并病理检查。19例相似部位的未行术前栓塞而直接手术的颅后窝实质性血管母细胞瘤作为对照组,两者作回顾性对比分析。结果微导管均到达供血动脉,注入适量250～350μmPVA颗粒后,9例肿瘤血管和肿瘤染色完全消失;7例肿瘤血管和肿瘤染色大部消失。16例栓塞后均顺利实施肿瘤手术全切除,与对照组相比,术中出血和输血量明显减少,手术时间缩短,手术视野清晰,肿瘤界限清楚,容易切除,且不易误伤邻近正常结构,9例完全栓塞者表现尤为显著。结论术前栓塞对血管母细胞瘤手术切除可使手术时间缩短,术中出血明显减少,肿瘤切除更为容易,邻近正常结构不易损伤,手术并发症及死亡率降低。Purpose:To determine whether preoperative embolization is a valuable adjunct to surgical excision of hemangioblastoma.Materials and Methods:Sixteen cases of hemangioblastoma in posterior cranial fossa proved by CT,MR and DSA were embolized preoperatively.In each case the feeding arteries were catheterized with microcatheter and were devascularized with polyvinyl alchol particles.Results:The blood supplies of the tumor in9cases were completely eliminated,and partial embolization was underˉgone in the other7case.1～7days later at surgery,the16tumors were totally resected with minimal blood loss and shortened operative procedure time.In addition,manipulation and removal of these emˉbolized tumors were subjectively easier than expected.No complications occurred during the procedures of embolization,two patient had complications after operation.Conclusion:Preoperative embolization of hemangioblastoma is a useful and relatively safe techenique to surgical complete resection of this hyperˉvascular tumor by significantly reducing blood loss at the time of surgery and operation procedure time.

关 键 词：颅后窝 实质性血管母细胞瘤 手术治疗 血管内栓塞 并发症 肿瘤 

分 类 号：R739.4[医药卫生—肿瘤]