小脑血管母细胞瘤的影像学诊断与外科治疗  

Imaging Diagnosis and Surgical Treatment of Cerebellar Hemangioblastomas

作　　者：吕健[1] 宋千[1] 权瑜[1] 巩守平[1] 

机构地区：[1]西安交通大学医学院第二附属医院神经外科,西安市710004

出　　处：《中国肿瘤临床》2012年第17期1318-1320,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨小脑血管母细胞瘤的诊断和治疗。方法:回顾性分析14例小脑血管母细胞瘤的临床和影像学特点、分型、治疗及其效果。结果:实质型5例,小囊大结节型4例,大囊小结节型5例,均行MRI平扫+增强扫描3例行全脑DSA检查,其中1例伴发颅内动脉瘤。手术治疗13例,全切除12例(92.31%);预后良好12例(92.31%),昏迷1例(7.69%)随访3～51个月,平均24.72个月,无复发。结论:MRI检查是诊断血管母细胞瘤的主要依据,由于该病有同时伴发动脉瘤的可能,建议将全脑DSA作为常规检查。显微手术是治疗小脑血管母细胞瘤的首选,术中可辅以神经内镜技术。Objective： To explore the diagnosis and surgical treatment ofcerebellar hemangioblastomas （ HGBs ）. Methods： The clinical and imaging features and classifications, as well as the surgery and treatment effects, of 14 cases with cerebellar HGBs were retrospectively analyzed. Results： Standard and contrast-enhanced magnetic resonance imaging （ MRI ） were performed for all patients. The MRIs revealed five cases with solid HGBs, tour with small cysts containing large nodules, and five with large cysts containing small nodules. Cerebral angiography was applied in three of the cases. One case with concurrent aneurysms was found. Microsurgical resection was conducted in 13 cases, with total resections in 12 of the said cases. Satisfactory outcomes were obtained in 12 cases after surgery, which were followed-up for a period of 3 to 51 months. No recurrence was observed in any of these cases. Conclusion： The results of MRI still form the main basis for diagnosing cerebellar HGBs. With the possibility of concurrent aneurysms, cerebral angiography should be considered as part of the routine examination. Microsurgical resection is the preferred treatment for cerebellar HGBs, and neuroendoscopes are valuable for the exploration of nodules in cysts.

关 键 词：血管母细胞瘤 诊断 治疗 

分 类 号：R739.4[医药卫生—肿瘤]