MRI液平显像对囊性前庭神经鞘瘤手术效果的评价  

Estimation of fluid-level imaging by MRI on surgical effect of patient with cystic vestibular schwannoma

作　　者：沈爱国[1] 夏雷[1] 张宏伟[1] 于春江[1] 

机构地区：[1]北京三博脑科医院神经外科首都医科大学第十一临床学院,100093

出　　处：《中国综合临床》2014年第11期1194-1196,共3页Clinical Medicine of China

摘　　要：目的 评价MRI液平显像对囊性前庭神经鞘瘤手术效果的影响.方法 选择45例囊性前庭神经鞘瘤患者,根据MRI影像学特点分为液平组24例,非液平组21例,对两组瘤周粘连率、全切率及面神经功能情况进行回顾性分析.结果 术中发现液平组和非液平组的瘤周粘连率分别为70.8％（17/24）和28.6％（6/21）,组间比较差异有统计学意义（x2=8.010,P＜0.05）;肿瘤全切率分别为45.8％（11/24）和76.2％（16/21）,组间比较差异有统计学意义（x2=4.300,P＜0.05）.出院及术后1年时进行House-Brackmann分级,Ⅰ～Ⅲ级者在液平组分别占62.5％ （15/24）和50.0％（8/16）,而在非液平组分别占81.0％（17/21）和83.3％（15/18）;出院时组间比较差异无统计学意义（x2=1.86,P＞0.05）,术后1年时组间比较差异有统计学意义（P=0.015）.结论 具有液平显像的囊性前庭神经鞘瘤与周围神经血管结构粘连的发生率更高,手术效果也较差,该发现有助于预测手术效果及手术策略的选择.Objective To evaluate the surgical outcome of cystic vestibular schwannoma patients with fluid-level imaging by MRI.Methods Forty-five patients of cystic vestibular schwannoma were enrolled and divided into fluid-level （n =24） group and non-fluid-level （n =21） group by MRI.The incidence of peritumoral adhesion,incidence of complete tumor removal and postoperative facial nerve function of the two groups were recorded.Results The incidence of peritumoral adhesion in fluid-level and non-fluid-level group were 70.8％ （17/24） and 28.6％ （6/21）,and the difference was significant （x2 =8.010,P ＜ 0.05）.The incidence of complete tumor removal were 45.8％ （11/24） and 76.2％ （16/21） in fluid-level and non-fluid-level group,which showed significant differences between groups （x2 =4.30 ; P ＜ 0.05）.Patients of House-Brackmann grade Ⅰ-Ⅲ in fluid-level group at discharge and one year after operation,were 62.5％ （15/24） and 50.0％ （8/16）,and 81.0％ （17/21） and 83.3％ （15/18） in non-fluid-level group.The was significant difference at one year after operation （P ＜ 0.05） in terms of patients of House-Brackmann grade Ⅰ-Ⅲ.Conclusion The cystic vestibular schwannoma patients with fluid level have more frequency to adhere to surrounding neurovascular structures and less favorable surgical outcome.These findings may be useful in predicting surgical outcome and making surgical strategy preoperatively.

关 键 词：前庭神经鞘瘤 液平显像 瘤周粘连 

分 类 号：R739.4[医药卫生—肿瘤]