陈建强,韩向君,史克珊,李刚,李香营,鲁宏,关莹,尤晓光,战跃福.CT血管成像在颅底脑膜瘤手术中的应用[J].中国医学影像技术,2010,26(4):631~634
CT血管成像在颅底脑膜瘤手术中的应用
Application of CT angiography in operation ofcranial base meningioma
投稿时间:2009-09-12  修订日期:2009-12-14
DOI:
中文关键词:  脑膜瘤  血管造影术  体层摄影术,X线计算机
英文关键词:Meningioma  Angiography  Tomography, X-ray computed
基金项目:海南省自然科学基金(808246)、海南省卫生厅科研立项课题(琼卫2006-32号)。
作者单位E-mail
陈建强 中南大学湘雅医学院附属海口医院放射科,海南 海口 570208  
韩向君 中南大学湘雅医学院附属海口医院放射科,海南 海口 570208 jilinhxj@163.com 
史克珊 中南大学湘雅医学院附属海口医院神经外科,海南 海口 570208  
李刚 中南大学湘雅医学院附属海口医院神经外科,海南 海口 570208  
李香营 中南大学湘雅医学院附属海口医院放射科,海南 海口 570208  
鲁宏 中南大学湘雅医学院附属海口医院放射科,海南 海口 570208  
关莹 海南医学院附属医院放射科,海南 海口 570208  
尤晓光 海南医学院附属医院放射科,海南 海口 570208  
战跃福 中南大学湘雅医学院附属海口医院放射科,  
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中文摘要:
      目的 探讨多排螺旋CT血管造影(MSCTA)对降低颅底脑膜瘤手术创伤的应用价值。 方法 对32例颅底脑膜瘤患者术前行MSCTA检查,观察瘤体的形态及其与邻近大血管、颅底骨质的三维关系;利用三维重建图像模拟手术操作,以术中所见为标准对照。同时随机抽取未接受MSCTA检查的22例颅底脑膜瘤患者作为对照组,比较两组的术中输血量和并发症的发生率。 结果 32例患者MSCTA皆清晰显示瘤体的形态及其与邻近大血管、颅底骨质的三维关系,与术中观察一致,通过模拟操作皆合理地设计了骨瓣的大小及形状,有效避免了瘤周重要血管的损伤,准确地评估了包裹动脉剥离的危险度,其中9例改变了常规手术入路和手术方式,4例术前早期制定了次全切手术方案及放疗计划。与对照组比较,患者术中输血量明显减少(P<0.05),术后并发症发生率也降低。 结论 MSCTA可以从多角度模拟手术操作,为术前制定手术方案提供重要信息,从而减少手术创伤和术后并发症。
英文摘要:
      Objective To probe the value of multi-slice spiral CT angiography (MSCTA) in decreasing surgical trauma of the cranial base meningioma. Methods Thirty-two patients with cranial base meningioma were examined preoperatively with MSCTA to observe the shape and the relationship with the adjacent vessels and the skull base. Three-dimensional images were reconstructed to imitate the approach of operation and compared with surgical findings. Meanwhile, 22 patients withnot MSCTA were selected randomly as control group. The amount of blood transfusion and the occurrence rate of complications were compared between the two groups. Results MSCTA depiceted clear three dimensional images of the meningioma and the relationship with the adjacent vessels and the skull base, corresponded very well to the surgery. By imitating the operation, all patients were designed the incision size of bone appropriately, the vessels of peritumoral were kept off effectively and the risk of the embedded vascular were assessed accurately. The conventional surgical approach and method were changed in 9 patients, 4 formulated the planning of the sub-total resection and radiotherapy preoperatively. Compared with control group, the amount of blood transfusion reduced significantly (P<0.05) and postoperative complications decreased. Conclusion MSCTA can imitate the surgical operations in multi-angle and supply the vital information for choosing the proper surgical approach, thereby reducing surgical trauma and postoperative complications.
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