中枢神经系统原发性血管炎的诊断与治疗

Diagnosis and treatment of primary angitis of central nervous system

目的研究中枢神经系统原发性血管炎（ＰＡＣＮＳ）的诊断与治疗方法。方法对１２例以占位性病变为突出表现的ＰＡＣＮＳ病人，回顾性分析其临床表现、影像特征及手术治疗结果。结果病变表现为低密度的ＣＴ、和长Ｔ１、Ｔ２的ＭＲＩ改变，７例ＭＲＩ环形强化病变呈花瓣样改变。病灶全切１０例，部分切除２例。病灶全切预后良好；部分切除者，残留病变继续生长。结论多数病人的病变影像改变有其特殊性，结合临床表现，能作出术前诊断。手术切除为目前最有效的治疗方法。

Objective To investigate methods for the diagnosis and treatment of primary angitis of cental nervous system (PACNS). Methods Radiological and clinical feature,operative resutls of 12 patients with mass lesion presentations of PACNS were analyzed retrospectively. Results The lesions showed low density on CT and long T1 and long T2 signal on MRI. The ring- wall enhanced lesions on MRI were flowery in 7 patients. Gross total resection of the lesions were performed in 10 patients with ex- cellent recovery postoperatively. Growth of lesions were observed in 2 patients who underwent subtotal Conclusions Lesions of PACNS have special appearance on enhanced MBI. More patients with mass lesion presentations of PACNS could be diag- nosed preoperatively according to radiological and clinical feature. For these patients, surgery is the optimal treatment at present.