上矢状窦旁脑膜瘤切除术前3D CE-MRV特征分析  

Preoperative characteristics of 3D CE-MRV for diagnosing parasagittal meningioma

作　　者：陈立坚[1] 陈科光[1] 黄盈盈[1] 潘盛章 

机构地区：[1]钦州市第一人民医院放射科,广西535000

出　　处：《中国临床新医学》2016年第3期234-236,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的总结分析上矢状窦旁脑膜瘤切除术前三维增强磁共振血管成像(3D CE-MRV)的临床特征。方法对19例上矢状窦旁脑膜瘤切除术前行3D CE-MRV检查,观察脑膜瘤与上矢状窦的位置关系,根据上矢状窦及邻近主要回流静脉受累的程度,制定手术计划,并与术中记录进行比较分析。结果 2例脑膜瘤位于上矢状窦旁前1/3,14例位于上矢状窦旁中后1/3,3例位于窦汇区。12例瘤体基底部或蒂部附着于上矢状窦壁外缘;4例瘤体侵蚀上矢状窦壁;3例瘤体长入上矢状窦内,窦腔完全闭塞。3D CE-MRV所示与手术结果完全相符,实施Ⅰ级切除14例,Ⅱ级切除4例,Ⅲ级切除1例,术中出血量最少70 ml、手术时间最短47 min、术后无并发症。结论 3D CE-MRV检查能够准确直观显示上矢状窦受侵的解剖结构,对上矢状窦旁脑膜瘤切除术前制定手术计划,降低手术风险具有重要的指导价值。Objective To summarize the guiding value of 3D CE-MRV for parasagittal meningionma resec- tion. Methods Nineteen patients with parasagittal meningionma were examined preoperatively with 3D CE-MRV, and the tumor＇s location, the situation of collateral venous pathways were observed to make the operation schemes, which were compared with the intraoperative findings. Results The meningiomas were found in one third of the loca- tion in the front of superior sagittal sinus in 2 cases, 14 cases in one third of the location in the middle of superior sagittalsinus, and 3 cases in torcular Herophili. The basal part or pedicle adhered to the outer layer of superior sagit- tal sinus was found in 12 cases, meningiomas in 4 cases grew into the outer layer of superior sagittal sinus, and men- ingiomas in 3 cases grew into and blocked the sinus cavity completely. All these manifestations on the images were i- dentical with the findings in the operation. Twelve cases were performed total resection, and 7 cases were performed subtotal resection. The minimum amount of bleeding during the operation was 70 ml, and the shortest time for the op- eration was 47 minutes. There was no any complication after the operation. Conclusion 3D CE-MRV examination can visually display the anatomic structures of the eroded superior sagittal sinus, which may be helpful for making the operation schemes and reducing the operation risks.

关 键 词：磁共振血管成像 上矢状窦旁 脑膜瘤 

分 类 号：R739.45[医药卫生—肿瘤]