MSCTA与DSA对脑膜瘤血供的对比研究

Comparision of MSCTA and DSA in nurturing vessels of menigioma

目的通过多层螺旋CT血管造影及数字减影血管造影两种检查方法对脑膜瘤血供进行对比评价,进一步了解两种检查方法在脑膜瘤血供方面的应用价值及优势。方法应用16层螺旋CT对20脑膜瘤患者进行CT血管造影检查,每个病例于一周后行数字减影血管造影检查,对脑膜瘤血供情况(包括瘤体供血动脉、引流静脉、静脉窦、对肿瘤周围血管走行及对颅骨的影响等方面)进行对比评价。结果 20例行MSCTA与DSA检查患者均清晰显示瘤体供血动脉、引流静脉及静脉窦,后者较前者在对细小分支的显示上略占优势;在近颅骨侧血管的显示方面DSA较MSCTA有明显优势;而在瘤体对周围血管的压迫、推移等方面MSCTA则具有三维立体的优势;窦旁脑膜瘤受侵的显示中,MSCTA可因骨质影响而高估静脉窦受侵情况的存在,DSA则不受影响;MSCTA可准确评估瘤体与骨质关系,并可为术前模拟手术入路提供三维立体影像。结论 MSCTA与DSA均能够提供准确的瘤体供血动脉、引流静脉及静脉窦等重要信息,具有较高的一致性,而在显示瘤体与周围血管、颅骨的三维关系以及无创、快捷、价格低廉等方面MSCTA更具优势。

Objective To further understand the application and advantages of multi-slice spiral CT angiography （MSCTA）compared with digital subtraction angiography （DSA）in blood supply of meningiomas. Methods The blood supply of 20 meningioma patients were determined by 16-slice spiral CT,then each case were exterminated by DSA in a week,the blood supply of meningioma （including tumor supplying arteries,drainage veins,venous sinus,the blood vessels around the tumor and influence on cranial bone etc.）were compared and evaluated. Results Tumor supplying arteries, drainage veins and venous sinus in 20 cases underwent MSCTA and DSA examination were clearly observed ,but DSA examination possessed slightly advantage in the display of the small branches and also with obvious advantages on the aspect of display near skull lateral vessel. While in the peripheral vascular compression of the tumor etc. MSCTA possessed advantage three-dimensional imaging; In display of sinus meningioma invasion ,MSCTA might overestimate the invasion to venous sinus due to the influence of bone,DSA would not be affected;MSCTA could accurately evaluate the relationship between tumor and bone,and provides three-dimensional imaging for preoperative simulation operation approach. Conclusions MSCTA and DSA can highly consistently provide accurate tumor supplying arteries,drainage veins ,venous sinus and other important information,while MSCTA has advantage in displaying three-dimensional relationship of tumor, peripheral vascular and skull, even more noninvasive, convenient and low cost.