三维血管成像在老年脑膜瘤患者术前的应用  

Preoperative application of three-dimensional angiography in elderly patients with meningioma

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

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

出　　处：《中华老年医学杂志》2012年第7期567-570,共4页Chinese Journal of Geriatrics

基　　金：海南省自然科学基金（808246）

摘　　要：目的 探讨三维血管成像在老年脑膜瘤中手术方案制定的应用价值。方法对42例年龄≥60岁的老年脑膜瘤患者进行多层螺旋CT血管成像（MSCTA）及或三维增强磁共振血管成像（3DCE—MRA）检查（模拟组），在三维成像处理工作站中进行术前手术风险分析，并以同期未经上述检查的28例老年脑膜瘤患者作为对照组。比较两组术中手术操作时间、出血量及术后并发症的差异。结果模拟组42例皆于术前合理地制定手术方案及手术人路，模拟组术后并发症发生率35．7％低于对照组50．0％（P〉0．05）；术中输血量（531．0±150．6）ml低于对照组（621．4±226．7）ml（t=2．01，P=0．049）；手术时间（257．1±72．6）min低于对照组（307．5±88．2）min（t=2．61，P=0．011）。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，帮助临床合理地制定手术方案及手术入路，降低手术创伤及并发症。Objective To study the preoperative application value of the three-dimensional angiography in surgical strategy for the elderly patients with meningioma. Methods Forty-two elderly patients aged 60 years and over with meningioma were examined preoperatively with multi-slice spiral CT angiography（MSCTA） and （or） 3 dimensional contrast-enhancement MR angiography（3D CE-MRA）as simulation group. In three-dimensional post-processing workstation, the oppression and invasion degree of the intracranial important blood vessels, nervous running zone and sinus, as well as surgical risks were evaluated. 28 elderly patients without the above examination were as control group. The operation time, blood transfusions and postoperative complications were compared between the two groups. Results All 42 cases of simulation group completed reasonable surgical plan and approach. The incidence of postoperative complications were lower in simulation group than in control group （35.7% vs. 50.0%, P〉0.05）, intra-operative blood transfusion were significantly decreased in simulation group as compared with control group [（5301.0 ±150.6） ml vs. （ 621.4 ± 226.7）ml, t= 2.01, P= 0. 0493, operation time after three-dimensional simulation were reduced as compared with control group [（257.1±72. 6） rain vs. （307.5±588.2）min, t=2.61,P=0. 0111. Conclusions Application of three-dimensional angiography in elderly patients with meningioma to evaluate the operative risk may help make reasonable surgical strategy, thus reducing the surgical trauma and complications.

关 键 词：脑膜瘤 磁共振血管造影术 成像 三维 

分 类 号：R739.4[医药卫生—肿瘤]