摘要
目的 探讨蝶骨嵴脑膜瘤血液供应的特点及其术前栓塞对手术切除的意义。方法5 2例蝶骨嵴脑膜瘤患者中 ,发生于右侧者 31例 ,左侧者 2 1例 ;5 2例患者全部行DSA造影 ,30例患者行颈外系统供血动脉栓塞治疗 ,栓塞治疗后 5～ 7d行手术切除。结果 (1)脑膜瘤的占位改变可导致邻近周围脑血管的异常改变。 (2 ) 5 2例患者中 ,单纯由颈外动脉系统分支供血的有 11例 ,颈外动脉分支和颈内动脉分支双重供血的 2 9例 ,单纯由颈内动脉系统供血的 12例。 (3) 30例行肿瘤供血动脉栓塞的患者中 ,2 5例采用明胶海绵颗粒栓塞 ,5例采用丝线栓塞。栓塞的颈外供血动脉主要为 :脑膜中动脉 18例 ,脑膜中动脉与脑膜副动脉同时被栓塞者 10例。栓塞后肿瘤染色明显减轻者 2 0例 ,染色消失者 5例 ,肿瘤染色减轻不明显者 5例。 (4 )栓塞后行手术切除的 30例患者中 ,2 4例被完整切除 ,而未行栓塞的 2 2例患者中 ,仅 10例被全切除 ,二者统计学上差异具有显著性意义 (χ2 =3.86 ,P <0 .0 5 )。结论 蝶骨嵴脑膜瘤的术前造影和栓塞有利于肿瘤的完整切除。
Objective To investigate the characteristic of blood supply of sphenoidal crest meningiomas and the meaning of pre-operative embolization for surgical incision. Methods Among 52 cases with sphenoidal crest meningiomas, 31 cases located in the right and 21 cases in the left. 52 cases all underwent DSA, with 30 cases undergoing external carotid artery embolization and surgical incision 5-7 days after embolization. Results (1) Occupying effect of meningiomas may lead to abnormal change of neighboring cerebral vessel. (2)Among 52 cases, only the branch of external carotid artery supply was revealed in 11 cases, both of external and internal carotid artery supply in 29, and only internal carotid artery supply in 12. (3) Among 30 cases undergoing embolization, 25 cases were treated using gelform powder and 5 cases using silk. Mainly embolized supplying artery: only middle meningeal artery in 18, both middle meningeal artery and accessory meningeal artery in 10. After embolization, tumor stain evidently decreased in 20, disappeared in 5, and slightly decreased in the other 5. (4)Among 30 cases undergoing surgical incision after embolization, 24 cases were wholly resected. Among 22 cases without embolization, only 10 cases were wholly resected. The difference was statistically significant. Conclusion Pre-operative cerebral angiographies and embolizations are beneficial for the total resection of sphenoidal crest meningioma.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2001年第12期911-914,共4页
Chinese Journal of Radiology
关键词
脑膜瘤
血管造影术
栓塞治疗
外科手术
Meningioma
Sphenoid bone
Angiography, digital subtraction
Embolization, therapeutic
