上矢状窦旁脑膜瘤患者镰状窦的MRV研究

目的　研究上矢状窦旁脑膜瘤（parasagittal meningioma,PSM）患者中镰状窦的发生率及其磁共振静脉成像（MR venography,MRV）影像学特点,为术中静脉保护提供依据。 方法　回顾性分析42例PSM患者的MRV特点,统计永存镰状窦和再通镰状窦的发生率及其分别与上矢状窦（superior sagittal sinus,SSS）狭窄程度之间的关系。 结果　42例患者中,永存镰状窦和再通镰状窦各有3例。再通镰状窦MRV表现为大小不一、片状、边界模糊的不均匀高信号带,范围大于永存镰状窦,但其信号强度较低。再通镰状窦的发生与SSS闭塞程度之间的差异有统计学意义（P=0.007）,其在SSS后1/3段重度闭塞脑膜瘤中的发生率为37.5%。 结论　镰状窦在PSM中并不少见,其MRV表现具有特征性。对于SSS后1/3段重度闭塞的脑膜瘤,术前应行MRV评估镰状窦,以减少静脉循环损伤。

MRV study of falcine sinus in parasagittal meningioma

Objective　To explore the incidence of falcine sinus in the patients with parasagittal meningioma (PSM) and its iconographical characteristics of magnetic resonance venography (MRV), which providing protection for intraoperative venous protection.　Methods　MRV data of 42 PSM patients were retrospectively analyzed and were observed the incidence of persistent falcine sinus and recanalized falcine sinus. Then the relationship of falcine sinus with the stenosis degree of the superior sagittal sinus (SSS) and its MRV imaging features were collected.　Results　In total 42 patients, 6 patients had falcine sinus. Three of them were persistent falcine sinus. In addition, three of them were recanalized falcine sinus. The recanalized falcine sinus showed a non-uniform high signal band with ununiform size, flake and blurred boundary on MRV, the range was larger than that of persistent sickle sinus, but its signal intensity was low. There were statistical difference between the incidence of recanalized falcine sinus and the occlusion degree of SSS (P=0.007). The incidence rate of recanalized falcine sinus occurring in meningioma in posterior 1/3 segment was 37.5%.　Conclusions　 Facline sinus is common in PSM, and its MRV manifestations are characteristic. In meningiomas invading the SSS, especially with complete posterior SSS occlusion, the falcine sinus should be evaluated preoperatively to avoid iatrogenic injury.