脑膜瘤术前栓塞治疗的临床评价

Clinical evaluation of the preoperative embolization of intracranial meningiomas

目的探讨脑膜瘤术前栓塞治疗的临床意义。方法 25例颅内脑膜瘤患者先行脑膜瘤栓塞,然后显微手术切除肿瘤;MRI检查评估栓塞和手术治疗效果。结果 25例脑膜瘤中,大脑凸面脑膜瘤2例,矢状窦旁脑膜瘤2例,蝶骨嵴脑膜瘤4例,鞍结节脑膜瘤3例,桥小脑角脑膜瘤3例,岩骨-斜坡脑膜瘤5例,脑室内脑膜瘤1例,中颅窝脑膜瘤4例,小脑幕脑膜瘤1例。栓塞后肿瘤血管染色完全消失16例,染色明显减轻9例。25例脑膜瘤患者均在栓塞后3～5d手术,病灶均被全部切除,术中平均出血150～500ml。栓塞后增强MRI检查显示除1例患者外,其余患者肿瘤病变内均无增强影像。结论脑膜瘤术前栓塞治疗会明显减少术中出血,缩短手术时间,降低手术难度,提高肿瘤的全切除率。

Objective To explore the clinical value of preoperative embolization of the intracranial meningioma.Methods The preoperative cerebral DSA and embolization,microsurgery and MRI were performed in 25 patients with intracranial meningiomas.Results Of 25 cases of meningiomas,2 were located in the cerebral convex,2 in the parasagittal region,4 in the sphenoidal crests,3 in the saddle nodules,3 in the cerebellopontine angles,5 in the petrosum-slopes,1 in the cerebral ventricle 4 in the middle cranial fossas and 1 in the cerebellar tentorium.The tumor blood dyeing completely disappeared in 16 patients and was significantly reduced in 9 patients after the embolization.The meningiomas were totally removed from 3 to 5 days after the embolization in all the patients.The volume of intraoperatie bleeding ranged from 150 to 500 ml.Postembolization enhancement MRI showed that there was not enhanced image in all the patients except 1 patient.Conclusion The preoperation embolization of the meningiomas can significantly reduce intraoperatie bleeding,shorten the time of operation,reduce operative difficulty and enhance the rate of total resection of the tumors.