双源CT三维血管成像技术在脑膜瘤术前评估中的应用

目的 探讨双源CT三维血管成像技术在脑膜瘤术前评估中的应用价值。方法 回顾性分析26例颅底或窦旁脑膜瘤患者的临床资料，术前行双源CT三维血管成像检查明确肿瘤与颅底血管或矢状窦之间的关系，根据肿瘤与血管关系切除肿瘤。结果 所有病例均能清晰显示脑膜瘤与周围血管、静脉窦之间的关系（包裹或推挤），术中所见与术前检查所见符合。术中对血管保护完全，无大出血，术后无脑梗死、脑出血。根据Simpson切除标准:2级切除16例，3级切除5例，4级切除4例。术后Karnofsky评分较术前平均提高20分。术后随访6~24个月，22例患者无复发；4例患者残留肿瘤复发，再次手术。结论 双源CT三维血管成像能够清晰显示脑膜瘤与周围血管、静脉窦的关系，有利于术中血管的保护，在脑膜瘤术前评估中具有重要的参考价值。

Application of three-dimensional dual-source CT angiography to preoperative assessment of meningiomas

Objective To explore the value of the three-dimensional dual-sources CT angiography (3D-DS-CTA) to preoperative assessment of meningiomas. Methods A retrospective analysis of the clinical data of 26 patients with skull base or parasigittal meningiomas, who received 3D-DS-CTA examination before the surgery in order to estimate the tumors with the blood vessels of skull base or sagittal sinus, was made. Results The relationships of the meningioma with peripheral vessels and venous sinus which were clearly shown by 3D-DS-CTA were consistent with intraoperative findings in all the patients. Of 26 patients, 16 received Simpson grade Ⅱ resection of the tumors, 5 Simpson grade Ⅲ and 4 Simpson grade Ⅳ. The blood vessels were protected well during the surgery. No postoperative complications including cerebral infarction and cerebral hemorrhage occurred in all the patients. The Karnofsky score after the surgery increased by 20 points compared with the preoperative one. The following up from 6 to 24 months showed that no tumors recurred in 22 patients and the tumors recurred in 4 patients who underwent surgery again. Conclusion The preoperative 3D-DS-CTA examination is of important value to the surgery for the skull base or parasigittal meningiomas because it can clearly show the relationship of the meningiomas with peripheral vessels and venous sinuses which is helpful to the intraoperative protection of the peripheral vessels.