MSCTA与3D CE-MRA对脑膜瘤血供的对比观察

Comparision of MSCTA and 3D CE-MRA in nurturing vessels of menigioma

目的探讨多排螺旋CT血管成像(MSCTA)与三维增强磁共振血管造影(3DCE-MRA)对显示脑膜瘤血供的价值。方法对20例脑膜瘤患者同时行MSCTA和3DCE-MRA观察瘤体血供,并对成像结果对比分析。结果两种方法皆能明确显示瘤体主要供血动脉及引流静脉;MSCTA较CE-MRA能够提供更多的瘤周细小供血动脉及引流静脉信息;12例大脑凸面脑膜瘤中,3DCE-MRA法同一平面完整显示近颅骨侧血管36条,MSCTA法仅显示16条;9例窦旁脑膜瘤CE-MRA皆立体、准确地提供窦腔结构受侵信息及侧支循环静脉通路,MSCTA对3例窦腔侵犯程度被低估或高估;MSCTA法显示10例骨质侵犯改变,CE-MRA法显示不明显。结论MSCTA与3DCE-MRA都能对脑膜瘤的血供特点进行术前评价;MSCTA对血管细小分支的显示优于3DCE-MRA,后者在瘤周静脉窦及近颅骨侧血管的评价因无骨质干扰而具有优势;MSCTA在显示骨质改变方面具有优势。

Objective To compare the clinical value of contrast-enhanced three-dimensional magnetic resonance angiography（3D CE-MRA） and multi-slice spiral CT angiography（MSCTA） in evaluating the blood supply of menigioma.Methods Twenty patients with menigioma underwent 3D CE-MRA and MSCTA examination.Then the images were analyzed.Results The main arteries and draining veins devoted in nurturing menigioma were clearly showed with 3D CE-MRA and MSCTA,and the latter could provide more information about small vessels.Meanwhile,36 adjacent skull vessels were integratedly showed with 3D CE-MRA in 12 patients with cerebral convex meningioma,while only 12 vessels were showed with MSCTA.The degree of invasion for sinus and collateral venous pathway in 9 patients with the meningiomas adjacent to the sinus were showed with 3D CE-MRA,while the degree of invasion for sinus were underestimated or overestimated in 3 patients with MSCTA because of the influence of osteoporosis.The change of osteoporosis in 10 patients was depicted.Conclusion Vessel formation can be provided by both 3D CE-MRA and MSCTA preoperatively.MSCTA is superior to CE-MRA in observing the small branch of vessels and changes of skull.CE-MRA has advantage on showing venous sinus and vessels near skull side.