海绵窦海绵状血管瘤的影像特征和显微手术

Characteristic MR imaging findings and surgical treatment of cavernous hemangiomas in cavernoussinus

目的总结海绵窦海绵状血管瘤的诊断和手术治疗经验，探讨其影像特征和手术要点。方法对2001年10月至2008年10月收治并手术切除的13例海绵窦海绵状血管瘤进行回顾性分析。病灶最大径3．5-6．0cm，均经MRl证实和显微手术切除。结果病变被全切除9例，大部切除3例，活检1例，无手术死亡。海绵窦神经保留情况：8例保留动眼神经；9例保留三叉神经第Ⅱ、Ⅲ支；其余均未能保留。结论海绵窦海绵状血管瘤可以根据其MRI的特征性影像获得确诊。合适的手术人路、娴熟的显微外科技术是全切肿瘤的必备条件。海绵窦内神经的保留仍然是未能完全解决的问题。

Objective To analyze the imaging character and surgical therapy of cavernous hemangiomas in cavernous sinus （CSHs）. Method From 2001 to 2008, 13 patients with CSHs were surgically treated in our department. The diameters of CSHs varied from 3.5 cm to 6. 0 cm. Results All the patients were operated on with no mortality. Complete tumor removal was achieved in 9 cases, partial tumor removal in 3 cases, and biopsy in 1 case. Cranial nerve Ⅲ was preserved in 8 cases and cranial nerves V2, V3 in 9 cases. In the other cases, cranial nerves in cavernous sinus were sacrificed unavoidably. Conclusions CSHs can be diagnosed preoperatively according to MRI and can be removed successfully by experienced surgeons who are familiar with operative approaches and microsurgical technique. However, great efforts should be made to decrease postoperative cranial nerve deficits.