摘要
目的 探讨小脑实性血管网织细胞瘤的影像学特征、诊断及鉴别诊断和手术注意事项。方法 对 1993年 3月～ 2 0 0 3年 3月治疗的 4 8例小脑实性血管网织细胞瘤患者的临床资料进行回顾性分析。所有患者术前均进行了CT和MRI检查 ,2 0例患者同时进行了DSA检查 ,16例患者术前进行了肿瘤供血动脉的栓塞治疗 ,5例患者术前行侧脑室 腹腔分流术。 4 8例患者的病灶部位分别为左小脑半球 14例 (其中 2例突入同侧桥小脑角 ) ,右小脑半球 12例 ,上蚓部 8例 ,下蚓部 7例 ,左天幕下6例 ,左小脑扁桃体 1例。结果 4 8例患者均在显微镜下达到全切除 ,1例术中发生正常灌注压突破 ,术后第二天出现消化道出血 ,其他患者术中术后均顺利 ,术中除自体血回输外 ,无一例输异体血 ,本组患者无手术死亡率 ,无明显手术并发症。结论 小脑实性血管网织细胞瘤为良性肿瘤 ,术中严格沿肿瘤包膜分离 ,先阻断供血动脉 ,后处理引流静脉 ,可以达到较少出血的完整切除 ,而肿瘤完整切除后不存在复发 ,可达到治愈。
Objective To study the clinical features, neuroimaging presentations, diagnosis and differential diagnosis, and operative warning events of the solid cerebellar hemangioblastoma. Methods The clinical data of 48 patients with solid cerebellar haemangioreticuloma were retrospectively analysed. Preoperative examinations included CT and MRI in all patients, DSA in 20, preoperative embolization of feeding arteries of tumor in 16,a preoperative ventriculoperitoneal shunt was placed in 5 cases. The lesion distribution of 48 patients was as follows: 14 lesions were situated in the left hemisphere of cerebellum with an extent into the cerebellopontine angle in 2 cases, 12 in right hemisphere of crerbellum, 8 in superior vermis, 7 in inferior vermis, 6 in left subtentorium, 1 in left cerebellar tonsil. Results The tumors of 48 patients were totally removed. One patient occurred normal perfusion pressure breakthrouth during surgery, and gastrointestinal hemorrhage on the second day after operation.Other patients all were intra and postoperatively uneventful. Except for autoinfusion, no patients transfused heterogenous blood. There were no operative mortality and serious complications in this series. Conclusions The solid cerebellar hemangioblastoma was benign neoplasm. Abiding by properly operative techniques, the optimal results can be obtained.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2004年第13期777-780,共4页
Chinese Journal of Surgery
