64层螺旋CT多期扫描在脑膜瘤术前评估中的应用

The Application of 64-slices Helical CT in Preoperative Appraisal of Meningiomas

目的探讨64层螺旋CT多期扫描在脑膜瘤术前评估中的价值。资料与方法21例脑膜瘤患者,均经64层螺旋CT平扫、增强动脉期和静脉期扫描,并行动脉期、静脉期和动静脉混合期减影。所得数据采用容积再现(VR)、最大密度投影(MIP)、多平面重组(MPR)行肿瘤、血管和颅骨成像,计算肿瘤体积,观察肿瘤部位、血供和邻近关系。结果21例中,大脑镰旁8例,蝶骨嵴5例,桥小脑角4例,大脑凸面2例,小脑幕旁1例,多发脑膜瘤1例。肿瘤体积5～86cm3。肿瘤动脉期呈轻、中度强化,静脉期显著强化,3例中心可见不规则囊变区。颈内动脉供血5例,颈外动脉供血14例,双重供血2例。颈内动脉被包绕受侵2例,静脉窦受侵5例,颅骨受侵9例,其余邻近血管受推压。结论64层螺旋CT多期扫描能直观、清楚地显示肿瘤与血管、颅骨的关系,对临床诊断及手术方案制定具有重要指导作用。

Objective To investigate the value of 64-slice helical CT muhiphase scanning in preoperative appraisal of meningiomas. Materials and Methods 21 cases with meningioma were performed unenhanced, arterial and venous phase enhanced scanning to acquire arterial phase and venous phase subtraction data. Volume rendering（ VR）, maximum intensity projedetion （MIP） and muhiplanar reconstruction （MPR） were used to reconstruct vessels, tumors and cranial bones. Tumors were merged with vessels and cranial bones. Tumors volume, site, blood supply were evaluated. Results Tumors located at Cerebralfalx lateral in 8 cases, crista sphenoidalis in 5 cases,cerebellopontine angle in 4 cases, convexity of brainin 2 cases, cerebellum tentorium lateral in 1 cases, and muhifocal meningiomas in 1 case. Tumors volume were 5cm^3 to 86cm^3. Tumors were gently or midrange enhanced in arterial phase, and significant enhanced in venous phase. 3 cases showed irregular necrosis. Blood supply from cervcal internal carotid artery in 5 cases, from external carotid artery in 14 cases, and duplexing blood supply in 2 cases. Cervcal internal carotid artery were invaded in 2 cases,venous sinuses were invaded in 5 cases, cranial bones were invaded in 9 cases, the rest vicinity tissue were compressed. Conclusion 64 slices helical CT muhiphase images can display the relationship of tumors, vessels and bones clearly, which are effective guidance in clinical diagnosis and therapy.