颅内海绵状血管瘤30例的临床和影像学特点

Clinical and imaging feature of 30 cayernousangioma cases

目的探讨颅内海绵状血管瘤（cavernousangiomas，CA）的临床与其MRI，CT和DSA表现特点及其诊断价值。方法回顾性分析经临床及影像学综合诊断（30例CA全部做MRI检查，26例同时作CT检查，12例同时作DSA检查）的CA30例。结果27例脑内型CA患者CT共发现病灶25个。CA的MRI平扫表现为T1WI呈等或低信号9个，高信号7个，混杂信号3个；T2WI呈高低混杂信号8个，26个病灶周围伴有低信号环，无占位效应；单发23例，占76．6％。病灶分布：颞叶7个，额叶9个，枕叶2个，顶叶1个，脑干1个，小脑半球1个，左侧侧脑室前角处1个，海绵窦3个，本组首发癫痫19例（63％），出血8例（27％），视蒙5例，反复出血者7例。本组手术切除病灶病理证实18例，在外院行λ刀治疗1例，术后癫痫有效控制6例，治愈出院12例。结论CA临床表现显示该病青中年较多，起病急且易复发。CA有典型影像表现，CT和MRI平扫对明确诊断具有重要意义，MRI优于CT，是首选和最佳影像学方法。除对于无症状CA患者行保守治疗外，有症状的患者一经诊断，可行手术治疗。

Objective To study the characteristic of cavernousangioma（ CA ） in clinical information and all films（MRI,CT,DSA） and value. Methods Retrospective analyze 30 patients of CA who were general inspected and diagnosed by clinic and imageology（ All were examined with MRI,26 with CT and at same time, 12 with DSA. ）. Results There are 25 focus of infection in 27 encephalon CA patients in CT scan. they were equal or low signal in 9 cases on T1WI,hypsosignal in 7 ,farrago signal in 3 and had farrago signal in 8 Patients on T2WI, low signal around focus of infection in 26, which was not to occupy place; one infection in 23 （76.6%）. the infection distribution is ：7 at temporal lobe ,9 at frontal lobe ,2 at occipital lobe and one in every apical lobe,brain stem,cerebellar hemisphere and left antecoronu, ,3 at cavemous sinus, 19 cases occurred epilepsy at the first time, hemorrhage in 8, vision vague in 5 and repetatur hemorrhage in 7 cases. 18 cases were proved by operation or biopsy, 1 was cured by k knife at other hospital, epilepsy were valid controlled after operation in 6 cases and 12 had good outcome. Conclusion CA occur more in middle-aged and young, onste urgently and easy to hemorrhage again. CA has typical appearance, CT or MRI scan were significancent in identify, MRI is the best and first imageology method, symptomatic CA shoud be operated once diagnoses except some expectant treatment for symptomless patients.