CT、MRA在老年脑膜瘤手术切除计划制定中的价值  

The Value of CT and MR Angiography in Surgical Planning for Elderly Patients with Meningiomas

作　　者：陈建强[1,2] 韩向君[1,2] 史克珊[1,3] 关莹[4] 战跃福[1,2] 李香营[1,2] 聂柳[1,3] 

机构地区：[1]中南大学湘雅医学院附属海口医院 [2]海口市人民医院放射科,海口570208 [3]海口市人民医院神经外科,海口570208 [4]海南医学院附属医院影像教研室,570208

出　　处：《临床放射学杂志》2011年第12期1742-1745,共4页Journal of Clinical Radiology

基　　金：海南省自然科学基金项目(编号:808246)

摘　　要：目的探讨三维血管成像在老年脑膜瘤手术切除计划中的应用价值。资料与方法对实施次全切手术的12例老年性脑膜瘤血管成像特点进行回顾性分析。结果 12例患者通过三维血管成像模拟操作早期制定次全切手术方案,其中3例瘤体基底较宽,单纯入路难以顾及入路远侧结构,2例瘤体深度包裹颅内重要动脉,3例侵及脑干或脑实质(功能区),2例瘤体位置较深,颅内重要血管阻碍手术操作窗,2例窦旁脑膜瘤静脉窦部分被侵犯,侧支循环通路建立不完善,术中所见与三维血管成像图像高度一致,术后一致认为手术计划合理。结论应用三维血管成像技术对老年脑膜瘤患者进行术前风险度评估,能帮助临床制定合理的手术方案,从而降低手术创伤及并发症,改善患者预后。Objective To study the value of CTA and MRA in surgical planning for the elderly patients with meningioma.Materials and Methods Twelve elderly patients（more than 60 years old） with meningioma who plan to receive subtotal resection were examined preoperatively with MSCTA and（or） 3D CE MRA.The CTA and MRA imaging characteristics were retrospectively analyzed.Results All the patients were made subtotal resection plans preoperatively according to the CTA and MRA results.The CTA and MRA findings included intracranial major artery embedded deeply by tumor in 2 cases of,it was difficult to exposed the distal part of the tumor with conventional surgical approach in 3 tumors with wide base,invaded to brain stem or brain parenchyma（functional area） in 3 cases,the operative windows were obviously hindered by major intracranial vessels in 2 cases deeply located,the collateral circulation pathways established imperfect in 2 cases with sinus invaded.The intraoperative findings were highly consistent with three dimensional angiography images,and surgical plan were appropriately designed according to angiography images.Conclusion Three dimensional angiography has great value in evaluating the risk and making surgical plan before surgery for elderly patients with meningioma.

关 键 词：脑膜瘤 血管造影术 次全切 老年 

分 类 号：R739.45[医药卫生—肿瘤]