中枢神经系统海绵状血管瘤

Cavernous angiomas of the central nervous system

目的：分析总结中枢神经系统海绵状血管瘤（ＣＡ）的临床和放射学特点及治疗效果。方法：回顾分析１５年间收治的ＣＡ７９例，其中颅内ＣＡ６０例，眶内１１例，椎管内８例。结果：本组平均病程４．３年，癫痫、局限性神经功能缺失，突眼和脊髓压迫症分别是上述部位ＣＡ的主要临床表现。ＣＴ多为高密度灶。ＭＲＴ１Ｗ以混合信号为主；Ｔ２Ｗ高信号多见，部分瘤周可见环状低信号。肿瘤获全切者占７９％，手术死亡率６％。４７例平均随访５．６年，临床改善或无症状者占９２％。结论：ＣＡ是生长缓慢的良性病变，手术治疗者效果较好；ＣＴ、尤其ＭＲ是诊断ＣＡ的最敏感方法。

Objective. To sdudy the clinical and radiological features and the therapeutic efficacy of cavernous angiomas (CA) in central nervous system. Methods: Retrospective analysis of 79 cases of CA treated in the last 15 years, including 60 intracranial cases, 11 intraorbital cases and 8 intraspinal canal cases were done. Results: The mean clinical course was 43 years. Seizures, focal neurological deficits, exophthalmos and spinal cord compression syndrome were the respective main presentation of CA in the above positions. CT showed high density lesions in most cases. MR T1W signal largely showed mixed signal intensity, T2W showed high signal intensity mostly, and the 'ring' sign of low T2 signal around CA could be seen in some cases. The tumors were totally removed in 79% of all the cases, and the operative mortality was 63%. Fourtyseven cases were followedup for average 56 years, 92% of them had clinical improvements or no symptoms. Conclusions: CA was a benign lesion which grow slowly. The results of management of these CA patients were good. CT, especially MR examination was the most sensitive method for diagnosis of CA.