CT脑池造影在颅内蛛网膜囊肿诊断及治疗中的应用

目的 探讨CT脑池造影(CTC)在颅内蛛网膜囊肿(IAC)诊断及治疗中的应用价值.方法 南方医科大学南方医院神经外科自2006年10月至2009年10月共收治23例IAC患者.其中非交通性蛛网膜囊肿(NCtAC)患者采用神经内镜造瘘并部分囊壁切除手术治疗,交通性蛛网膜囊肿(CIAC)患者采用保守治疗,通过患者手术前后CT、MRI及CT脑池造影(CTC)检查,分析CTC在鉴别诊断CIAC和NCIAC、评价手术治疗NCIAC的效果中的作用. 结果 CTC证实本组患者中17例为NCIAC即真性囊肿,6例为CIAC即假性囊肿;随访术后NCIAC患者CT或MRI检查显示1例囊肿消失,13例囊肿有不同程度缩小,3例无明显变化.随机抽取8例NCIAC患者行CTC检查显示囊肿与脑池沟通良好. 结论 CTC对颅内囊性病变的诊断,尤其是对CIAC和NCIAC的鉴别诊断中的作用尤为重要,CTC检查为颅内囊性病变是否手术治疗提供明确指征,并且术后CTC检查可初步评价囊肿手术效果.

CT cisternography in the diagnosis and treatment of intracranial arachnoid cyst

Objective To evaluate the value of CT cisternography (CTC) in the diagnosis and treatment of intracranial arachnoid cysts (IAC). Methods CTC was performed on 23 patients with IAC, admitted to our hospital from October 2006 to October 2009. Patients with non-communicating intracranial arachnoid cysts (NCIAC) accepted endoscopic neurosurgery and those with communicating intracranial arachnoid cysts (CIAC) accepted conservative treatment. CT, MRI and CTC were performed on these patients before and after the treatment; the value of CTC in the diagnosis and treatment of IAC and the effect of neurosurgery in the treatment of NCIAC were analyzed, respectively. Results CTC conformed that 17 patients (17/23) had NCIAC and 6 (6/23) had CIAC. All of the NCIAC patients were performed neuroendoscopic surgery: the cyst of 1 patient disappeared; that of 13 shrunk and that of 3 did not changed. Postoperative CTC demonstrated that all the cysts of the 8 patients communicated well with the cistern. Conclusion CTC is very important in the diagnosis of IAC,especially in the differentialdiagnosis of NCIAC and CIAC. The result of CTC can be an indicator in determining the necessity of operation in patients with cranial cysts and give a primary evaluation on the effect of cranial cyst surgery.