鞍隔脑膜瘤的分型及手术方法的选择

The types and the approaches of 20 diaphragma sellae meningiomas

目的 :探讨不同部位鞍隔脑膜瘤 (DSM)的分型以及手术方法的选择与治疗结果的关系。 方法 :CT扫描提示为垂体瘤和鞍结节脑膜瘤并向后发展者 ,用MRI复查筛选共发现DSM 2 0例 ,其中 9例为A型 (居鞍隔上垂体柄前 ) ,5例为B型 (居鞍隔上垂体柄后 ) ,2例为C型 (居鞍隔下蝶鞍内 ) ,4例为混合型 (累及鞍隔上下和垂体柄前后 )。 结果 :2 0例均行手术治疗 ,17例全切除 ,3例大部切除 ,无手术死亡和严重功能障碍。 结论 :MRI是诊断DSM的最好方法 ,有助于鉴别诊断、分型和手术方法的选择。

Objectives:To study the types, approaches and treatment results of diaphragma sellae meningiomas(DSM). Methods:Twenty cases were diagnosed as DSM by MRI,9 cases belonged to type A,5 belonged to type B,2 belonged to type C, and 4 belonged to type D. Results:Total removal of DSM was in 17 patients, and partial removal in 3 patients. Neither postoperative mortality nor severe morbidity occur. Conclusions:MRI is the best method for DSM. Surgery for DSM is more difficult than tuberculum sellae meningiomas because of the deep location, particularly for the large tumors that included type A,B and C.