320排CT三维血管成像技术在脑膜瘤术前评估中的应用  

Application of 320 slice CT angiography in preoperative evaluation of meningioma

作　　者：莫小军[1] 徐元昌[1] 杜飞州 杨金钢[1] 耿学龙 

机构地区：[1]中国人民解放军成都军区总医院放射科,成都630083

出　　处：《放射学实践》2016年第10期923-927,共5页Radiologic Practice

摘　　要：目的:探讨320排CT三维血管成像技在颅内脑膜瘤术前评估中的价值。方法:回顾性分析了经手术病理证实的36例颅内脑膜瘤患者的CT三维血管成像资料,所有患者术前均接受320排CT脑血管检查,并采用MPR、VR、MIP等三维后处理,观察及评估肿瘤与周围血管及静脉窦的关系,并与术中结果比较,分析CT血管成像术前诊断与术中所见是否一致。结果:36例CTA中34例均清楚显示脑膜瘤的供血血管,其中颈外动脉供血9例,颈外、颈内动脉共同供血8例,颈内动脉供血17例,2例供血动脉显示不清。CTA结果与术中所见比较,显示供血动脉率94.4%(34/36),准确判断符合率85.3%(29/34)。CT静脉成像(CTV)示17例窦旁脑膜瘤中2例静脉窦正常,未受肿瘤侵犯,与术中所见一致,15例静脉窦不同程度受肿瘤侵犯,其中Ⅰ型5例,Ⅱ型7例,Ⅲ型3例,而术中示14例静脉窦受侵,1例未受侵,CTV与术前诊断符合率为94.1%(16/17);其余19例其他部位与静脉窦分界清晰,与术中所见一致。结论:320排CT血管成像术能清楚显示颅内脑膜瘤与邻近动脉、静脉的关系,对临床选择最佳手术入路、确定肿瘤切除范围和处理周围血管有重要的意义。Objective：To investigate the value of 320-slice CT angiography（CTA）in preoperative evaluation of the patients with intracranial meningioma.Methods：A total of 36 pathologically confirmed patients with intracranial meningioma who had preoperative CTA data were retrospectively analyzed in this study.All patients underwent preoperative 320-slice CT angiography examination with the post-processing of MPR,VR,and MIP.The relationship between the tumor and surrounding arteries and venous sinuses were observed and assessed.The consistency between preoperative CT angiography and surgical findings were assessed.Results：In all 36 cases,34cases（94.4%）showed the feeding vessels of meningioma clearly by preoperative CTA,the other 2cases did not.The feeding vessels came from external carotid artery（n=9）,internal carotid artery（n=17）,and both（n=8）.Of the 34 cases,29cases（85.3%）described the feeding vessels which were in consistent with surgical findings.Of the 36 cases,17meningioma located close to venous sinuses,19 cases located far away from venous sinuses.Of the 17 meningioma close to venous sinuses,preoperative CTV described invasion of the sinuses in15cases（typeⅠ,n=5;typeⅡ,n=7;type Ⅲ,n=3）and no invasion in the other 2cases,which was in agreement with surgical findings in 16cases（94.1%）.All other 19 cases achieved good consistency（100%）between preoperative CTA and surgical findings.Conclusion：320-slice CTA can clearly describe the relationship between intracranial meningiomas and surrounding vessels,which was very helpful for choosing the best surgical approach,deciding the extent of tumor resection,and management of the surrounding vessels before surgical operation.

关 键 词：脑膜瘤 体层摄影术 X线计算机 术前评估 

分 类 号：R739.45[医药卫生—肿瘤] R730.44[医药卫生—临床医学]