高分辨率三维增强MRA评价脑膜瘤血供

目的 探讨高分辨率三维增强磁共振血管造影(3D CE-MRA)对脑膜瘤血供及邻近静脉窦的诊断价值.方法 对30例脑膜瘤患者进行3D CE-MRA检查,应用MPR、MIP三维重建技术,对脑膜瘤的血供进行观察.结果 30例脑 膜瘤中有14例颅内动脉参与供血;有16例脑膜瘤将颅内大血管推移、压迫,但跨过肿瘤段没有直接分支到肿瘤;供血动脉与脑膜瘤呈簇状分布;静脉呈"抱球状"分布在肿瘤的表面.回流到附近的浅静脉或静脉窦;13例窦旁脑膜瘤8例静脉窦受侵,清晰显示窦腔内改变及侧支循环静脉通路;17例大脑凸面脑膜瘤能够在同一平面完整显示近颅骨侧血管的起止点及走行路径.结论 通过应用高场强3D CE-MRA可以显示脑膜瘤的供血动脉、引流静脉,肿瘤与颅内大血管的关系以及窦旁肿瘤与静脉窦的关系,整体的显示供血动脉及引流静脉的走行途径等重要临床信息,为手术治疗提供帮助.

High-resolution contrast-enhanced three-dimensional magnetic resonanceangiography evaluation of nurturing vessels of meningioma

Objective To study the clinical value of high-resolution contrast-enhanced three-dimensional magnetic reso- nance angiography(3D CE-MRA)in evaluating the nurturing vessel of meningioma and the adjacent dural sinuse.Methods Thirty patients with meningioma were examined preoperatively with 3D CE-MRA and observed the nurturing vessels and the dural sinuse.Results Arteries devoted in nurturing meningioma in 14 cases,while intracranial large arteries were moved and oppressed by the tumor in the other 16 cases.The veins distributed on the surface of tumor like"grip the globe"and drain- aged into the adjacent superficial veins and sinus veins.Of 13 patients with the meningiomas adjacent sinus,8 patients ap- peared invasion of sinus lumina,3D CE-MRA exactly displayed the degree of invasion for sinus and collateral venous path- way.In 17 patients with cerebral convex meningioma,3D CE MRA integrated the vessal's connection point and detailed pathway which adjacent skull into one image.Conclusion 3D CE MRA could display the nurturing arteries,drainage veins and the relationship between meningioma and the adjacent sinus,so as to depict the overall course of the vascular channels completely,and it can supply the important information for operation.