螺旋CT三维血管成像技术术前评估颅底脑膜瘤的价值

目的探讨螺旋CT三维血管成像(3D-CTA)技术术前评估颅底脑膜瘤的价值。方法回顾性分析2012-01—2013-12我院收治的术前诊断为颅底脑膜瘤52例患者,于术前1周行3D-CTA及MRI相关检查,比较3D-CTA及全脑血管造影(DSA)对脑肿瘤血供情况的诊断,并与术中所见进行比较,术前根据3D-CTA及MRI检查结果确定手术方案。结果3D-CTA术前诊断肿瘤单纯颈外动脉供血25例,单纯颈内动脉供血14例,颈内外混合供血13例,DSA术前诊断单纯颈外动脉供血28例,单纯颈内动脉供血12例,颈内外混合供血12例;经比较两种诊断方式对患者术前肿瘤血供情况诊断差异无统计学意义(P0.05);术中所见患者肿瘤单纯颈外动脉供血25例,单纯颈内动脉供血12例,颈内外混合供血15例,3D-CTA术前扫描诊断与术中所见差异无统计学意义(P0.05)。结论 3D-CTA术前扫描能够有效显示颅底脑膜瘤患者的肿瘤血供情况、肿瘤及其周围血管的关系,对于术前手术方案的制定具有指导性意义,增加了患者手术的安全性,值得临床推广。

Application of three-dimensional spiral computed tomographic angiography (3D-CTA)to evaluate skull base meningioma

Objective To explore the application value of three-dimensional spiral computed tomographic angiography (3D-CTA)in the evaluation of skull base meningioma.Methods Fifty-two cases diagnosed with skull base meningioma before operation in our hospital from January 2012 to December 2013 were enrolled in our study.One week before operation all cases received both 3D-CTA and MRI examinations,then tumor’s blood supply described by 3D-CTA versus by DSA method was compared,and which was compared with the findings of surgery.Based on the results of preoperative 3D-CTA and MRI,we i-dentified surgery protocol.Results The preoperative diagnosis by 3D-CTA showed that tumor’s blood supplied by mere exter-nal carotid artery occurred in 25 cases,mere internal carotid artery in 14 cases,both external and internal carotid arteries in 13 cases.The preoperative diagnosis by DSA showed that tumor’s blood supplied by mere external carotid artery occurred in 28 cases,mere internal carotid artery in 12 cases,both external and internal carotid arteries in 12 cases.There was no difference between the two diagnostic exanimations for tumor’s supply blood.During the surgery,tumor’s supply blood was from mere external carotid artery in 25 cases,mere internal carotid artery in 12 cases and both external and internal carotid arteries in 1 5 cases.Compared with results presented by preoperative 3D-CTA,the findings of surgery showed no difference(P >0.05).Con-clusion Preoperative scanning by 3D-CTA can effectively reveal the tumor’s supply blood,clear the correlation of tumor with surrounding vessels and guide the surgery protocol before operation and accumulate operational safety in skull base meningioma patients,which should be clinically popularized and applied.