介入栓塞联合手术治疗巨大脑膜瘤(附12例报告)

目的 评价巨大脑膜瘤术前介入栓塞的优势。方法 回顾性分析12例巨大脑膜瘤病人的临床资料和影像学特点。肿瘤分别位于颅前窝、岩部、矢镰旁，最大直径7．1～9．6cm，均由多支颈内、外动脉分支供血。术前均经选择性血管内途径，应用颗粒、明胶海绵、丝线等材料进行栓塞治疗。栓塞后3～5d行开颅手术切除肿瘤。结果 肿瘤完全栓塞4例，部分栓塞8例。术中出血量300～1000ml。术后复查MR示肿瘤完全消失，临床症状消退，无明显并发症。结论 巨大颅内脑膜瘤供血丰富，手术切除前应用介入造影可了解肿瘤血运情况，避免术中损伤重要血管；栓塞治疗可减少术中出血，增加手术全切率，减少并发症发生。

Preoperative embolization combined with surgical resection for large meningiomas:report of 12 cases report

Objective To evaluate the value of embolization before surgical resection for large meningiomas. Methods The clinical data and imaging features of 12 patients with large meningiomas were analyzed retrospectively, The tumors located variously at the anterior cranial fossa, petrous pyramid or para-sagittal sinus, The diameter ranged from 7.1 to 9.6 cm, The blood supply came from the bi-lateral carotid artery in angiographic examination. All the tumors underwent preoperative were embolized 3 to 5 days before, Results Complete embolization was achieved in 4 cases, while semi-embolization in 8, Blood loss was from 300 to 1000 ml during operation. No marked complications were seen after operation. No tumor existed on postoperative MR examination images. Conclusion The large meningiomas have rich blood supply, preoperative DSA can show the blood supply of the tumor, and prevent the intraoperative injuries, Preoperative embolization is beneficial to tumor resection via decreasing the blood supply, increasing total resection rate, and decreasing complications.