DSA、术前栓塞在上矢状窦旁脑膜瘤手术中的价值

Significance of digital subtraction angiography and preoperative embolization in resection of parasagittal meningiomas

目的研究DSA在明确上矢状窦旁脑膜瘤血供情况、引流静脉代偿及矢状窦阻塞中的作用。方法回顾性分析41例矢状窦旁脑膜瘤病人的病历资料,比较术前未进行DSA检查组、DSA检查组和DSA加栓塞组之间术中出血、手术时间、手术全切肿瘤程度情况。结果DSA检查组和DSA加栓塞组较未进行DSA检查组手术全切率高(P< 0.05);DSA加栓塞组较未栓塞组术中失血少(P< 0.05);各组间手术时间无显著性差别(P> 0.05)。结论术前行DSA检查可以明确矢状窦旁脑膜瘤的血供、引流静脉代偿及矢状窦阻塞情况,能指导术前栓塞以减少术中出血,并为手术全切脑膜瘤提供有用信息。

Objective To investigate the roles of Digital Subtraction Angiography (DSA) in evaluating the blood supply of parasagittal meningioma, the draining vein compensation, and sagittal sinus obstruction, and evaluate the effect of preoperative embolization on reducing blood loss during resection of meningioma and increasing resection rate of meningioma. Methods The data of 41 patients with parasagittal meningioma were analyzed retrospectively. The intraoperative blood loss, operation duration, and total resection rate of meningioma were compared between non-DSA, DSA, and DSA combined with embolization treatment groups. Results There was significant difference in resection rate between DSA and non-DSA groups (P < 0.05). The blood loss was significantly less in preoperative embolization group than in non-embolization group(P < 0.05). The operation duration did not differ significantly between the three groups(P > 0.05). Conclusions Preoperative DSA is beneficial for evaluating the blood supply of parasagittal meningioma, draining vein compensation, and sagittal sinus obstruction, and may guide preoperative embolization of meningioma so as to reduce intraoperative blood loss and increase total removal rate of meningioma.