颅内蛛网膜囊肿的CTC诊断及临床意义

目的探讨颅内蛛网膜囊肿(intracranial arachnoid cyst,IAC)的CTC影像学分类与临床意义。方法对22例CT诊断为IAC病人行CT蛛网膜下腔-脑池造影(CTcisternography,CTC),根据CTC囊肿内是否有造影剂充盈进行分类。选择非交通性蛛网膜囊肿(noncommnicating intracranial arachnoid cyst,NCIAC)病例,行神经内镜下NCIAC-脑池/脑室造瘘术治疗。结果22例IAC病例经CTC检查15例确诊为NCIAC,阳性率为68.2%,NCIAC病例有确切的神经系统症状体征,术后症状改善或消失。9例NCI-AC病人CT随访示囊腔明显缩小,脑组织复位。结论①CTC简便、安全,对IAC病人具有诊断特异性,运用CTC可分类交通性蛛网膜囊肿(commnicating intracranial arachnoid cyst,CIAC)和NCIAC;②症状性NCIAC具有神经外科手术指征。

Intracranial Arachnoid Cysts: CT Cisternography and Its Clinical Significance

Objective To explore the classification of intracranial arachroid cysts(IAC) in CT cisternography(CTC) and its clinicalapplication.Methods 22 cases of IAC diagnosed by plain CT underwent CTC exminaton. IACs were classified into noncommnicatingintracranial arachnoid cyst (NCIAC) and commnicating intracranial arachnoid cyst (CIAC) by wheather or not filled with contrast media in cysts on CTC. NCIAC cases were selected and treated with neuroendoscopic fenestration.Results 15 cases of NCIAC were found by CTC examination. All the NCIAC patients had definite neurologic findings. Postoperatively, all the patients were improved or cured. Follow-upplain CT scan of 9 NCIAC cases showed the cysts were decreased markedly in size, most of the space around the cysts were replaced bynormal cerebral tissue.Conclusion (1)CTC is simple ,safe and specific for making a final diagnosis of IAC. IACs can be classified into CIAC and NCIAC by CTC findings.(2)Neurosurgical indication for IAC is NCIAC patients with symptoms.