显微手术联合介入栓塞治疗巨大脑膜瘤

目的探讨数字减影血管造影（DSA）对脑膜瘤术前栓塞的临床效果。方法回顾性分析14例巨大脑膜瘤患者的临床资料和影像学特点,肿瘤最大直径6.1-8.5 cm,均由多支颈内、外动脉分支供血。在术前5-7 d,对14例巨大脑膜瘤行DSA检查和微导管超选择栓塞肿瘤供血动脉,栓塞材料包括PVA颗粒、明胶海绵等。栓塞后行手术切除肿瘤。结果肿瘤完全栓塞4例,部分栓塞10例。术中出血量300-1000 ml。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,减少并发症发生。

Surgical resection combined with preoperative embolization for large meningiomas

Objective To evaluate of embolization before surgical resection for large meningiomas.Methods The clinical data and imaging feature of 14 patients with large meningiomas were analyzed retrospectively.The diameter of the tumors ranged from 6.1 to 8.5 cm,the blood supply came from the bi-lateral carotid artery.5~7 days before operation,14 patients with large mengingiomas underwent DSA and properative superselective embolization with PVA particles,gelatin sponge.The surgical intervention was performed after embolization.Results Complete embolization was achieved in 4 cases,while semi-embolization in 10.Blood loss was from 300 to 1000 ml during the operation.No marked complications were seen after operation.No tumor existed on postoperative MR examination images.Conclusion The large meningiomas have rich blood supply,properative DSA can show the blood supply of the tumor,and prevent the intraoperative injuries.Preopative embolization is beneficial to tumor resection via decreasing the blood supply,decreasing comliications.