脑膜瘤35例血供分析  

The feeding vessels of meningioma:an analysis of 35 cases

作　　者：陈建强[1] 韩向君[1] 战跃福[1] 陈晶[1] 史克珊[2] 李香营[1] 

机构地区：[1]海南省海口中南大学湘雅医学院附属海口医院放射科,570208 [2]海南省海口中南大学湘雅医学院附属海口医院神经外科,570208

出　　处：《介入放射学杂志》2011年第1期53-56,共4页Journal of Interventional Radiology

基　　金：海南省自然科学基金(808246)

摘　　要：目的探讨DSA对脑膜瘤血供的诊治价值及优势。方法分析海口医院2005年7月-2010年6月35例脑膜瘤术前DSA检查及手术资料,观察瘤体血供及部分患者栓塞治疗后DSA图像的特点,并以术中所见为标准对照。结果 35例脑膜瘤患者显示瘤体的供血动脉来源手术符合率为91%;邻近大血管受压移位程度、引流静脉及静脉窦受累情况手术符合率为100%;诊断瘤体丰血度中14例符合、8例被低估,符合率64%,14例血供丰富者2例存在危险吻合,12例行术前辅助性栓塞治疗,术中出血量得到很好控制,手术切除范围理想。结论 DSA能够准确评价脑膜瘤的血供特点,并能进行栓塞治疗,对临床术前手术方案的制订及术中出血量的控制具有重要意义。其在观察瘤体动脉来源及评价丰血度方面存在一些不足,但随着设备技术的不断改进以及辅以其他技术设施,DSA仍是脑膜瘤血供诊治的重要手段之一。Objective To study the diagnostic value of digital subtraction angiography（DSA） in evaluating the feeding vessels of meningioma and in making the therapeutic schedule.Methods Thirty five patients with meningioma,who had complete DSA and surgical information and were encountered in our hospital during the period of July 2005 to June 2010,were enrolled in this study.The clinical data,the feeding vessels of the tumor and the DSA features after embolization therapy were analyzed.The surgical findings were taken as the gold standard.Results The origin of tumor-feeding arteries detected on DSA was consistent with that confirmed by surgery in 91% patients.With respect to the shift degree of adjacent larger vessels and the involvement of drain veins and venous sinus,the coincidence rate between DSA and surgery was 100%.General agreement concerning the blood supply degree was obtained in 14 patients,while the blood supply was underestimated in 8 patients,with a coincidence rate of 64%.Of 14 patients with rich blood supply,dangerous anastomosis was present in two,and pre-operative adjuvant embolization was employed in 12.The blood loss during operation was well controlled and the ideal excision extent was accomplished.Conclusion DSA can accurately evaluate the blood supply of meningioma and preoperative embolization can be carried out,which is of great significance for making surgical program preoperatively and for controlling the blood loss during the intervention.DSA have some limitation in confirming the origin of the tumor-feeding artery and in evaluating the abundance of blood supply.The device and technology together with the use of other technical facilities are steadily developing,even though DSA is still one of important means for the diagnosis and preoperative treatment of meningioma.

关 键 词：脑膜瘤 DSA 血供 

分 类 号：R739.45[医药卫生—肿瘤]