脑膜瘤血管造影及术前栓塞治疗

目的 探讨数字减影血管造影对脑膜瘤的诊断价值及术前栓塞的临床效果。方法 选择脑膜瘤58例行全脑血管造影,对颈外动脉主要参与供血者进行血管内栓塞。结果 58例脑膜瘤中,血管造影显示肿瘤由单纯颈外动脉或以颈外动脉供血为主者43例。经颈外动脉分支用250~350μm颗粒栓塞剂实施栓塞,肿瘤染色完全消失31例,大部消失12例。无栓塞相关并发症。于血管造影、栓塞后1~7d手术,肿瘤全切53例,大部切除5例。栓塞后肿瘤出血明显减少,平均出血量600ml。结论 数字减影血管造影是脑膜瘤重要的诊断手段之一,术前栓塞可使术中出血减少,手术时间缩短,是一种安全、有效的辅助治疗措施。

Digital subtraction angiography and preoperative embolization for meningiomas

Objective To investigate the diagnostic value of digital subtraction angiography (DSA) and the clinical efficacy of preoperative embolization for miningiomas. Methods Fifty-eight patients with meningioma were examined by DSA, and preoperative embolization was performed in patients whose miningiomas were supplied predominantly by the external carotid artery (ECA). Results In 43 patients, the meningiomas was exclusively or predominantly supplied by ECA, and the feeding arteries were embolized with particles of 250-350 μm through catherization of ECA. The blood supply of the tumor in 31 patients was completely blocked, and partial occlusion through embolization was performed in 12 patients. No complications in relation to the embolization occurred. Fifty-three patients underwent total removal of the meningiomas and the others had partial removal 1-7 days following DSA and embolization, with tumor-associated intraoperative hemorrhage of 600 ml on average. Conclusion DSA has important diagnostic value for meningiomas, and preoperative embolization can be safe and effective to reduce bleeding, shorten the operation time and prevent postoperative complications.