原发性颅骨内脑膜瘤的诊断与治疗(附4例报告并文献复习)

Diagnosis and Treatment of Primary Intraosseous Meningiomas (a Report of 4 Cases and Review of Literatures)

目的探讨原发性颅骨内脑膜瘤的病理发生机制,诊断与治疗。方法4例原发性颅骨内脑膜瘤术前均进行了CT和/或MRI检查,随后均经显微外科治疗。术后均经过病理检查确诊,同时结合文献并对其发生机制、诊断和治疗进行讨论。结果4例颅骨内脑膜瘤均全切除,同时切除了其周围部分颅骨。病理检查显示,4例颅骨内脑膜瘤中,砂粒型2例,脑膜上皮型和恶性脑膜瘤各1例。结论颅骨内脑膜瘤的发生机制尚不完全清楚,但起源于胚胎脑发育期间残留的蛛网膜细胞可能性大,结合临床表现及CT、MRI检查一般可以诊断,但确诊需进行病理检查,手术治疗效果好。

Objective To explore the pathogenesis, diagnosis and treatment of primary intraosseous meningiomas. Methods The preoperative CT and/or MRI examinations were performed in 4 patients with primary intraosseous meningiomas. The primary intraosseous meningiomas, which were treated by microsurgery, were definitely diagnosed as by postoperative pathological examination in 4 patients. The their pathogenesis, diagnosis and treatment were analyzed. Results The total tumors and cranial bone around them were removed in 4 patients with intraosseous meningiomas. The pathological examination showed that of 4 cases of the intraosseous meningiomas, 2 were psammomatous meningiomas, 1 was malignant one and 1 meningiothelial one. Conclusions The pathogenesis of intraosseous meningiomas, which may be derived from the residual intraosseous arachnoidal cells during the embryo development, is not completely clarified. The intraosseous meningiomas may be diagnosed as by combined its clinical manifestation with imaging examination （CT and MRI）. The curative effect of microsurgery on the intraosseous meningiomas is good.