颅后窝血管母细胞瘤MRI分型与手术疗效的关系

The relationship between MRI classification and surgical treatment of posterior cranial fossa angioreticuloma

目的探讨颅后窝血管母细胞瘤MRI分型与手术切除的关系。方法回顾性分析16例经手术和病理证实的颅后窝血管母细胞瘤患者MRI分型与手术切除的关系。根据肿瘤MRI影像学特点分为囊壁结节型、囊实型、实体型,依照不同分型设计个体化手术方案切除肿瘤。结果本组患者中囊壁结节型7例、囊实型5例、实体型4例;其中肿瘤位于小脑半球10例,位于小脑蚓部2例,位于延髓背侧面4例;MRI分型与术中所见基本一致,16例患者手术全部切除肿瘤,无严重并发症,无死亡者。结论颅后窝血管母细胞瘤MRI分型能反映肿瘤的病理形态及血供,为术前制定个体化手术方案提供了帮助,降低了手术风险和并发症,提高了颅后窝血管母细胞瘤的显微外科治疗效果。

Objective To analyze the relationship between the classification of magnetic resonance imaging（ MRI） and surgical treatment for posterior cranial fossa hemangioblastoma. Methods We retrospectively analyzed 16 cases of posterior cranial fossa hemangioblastoma,which were confirmed by surgery and pathology,to study the realation between their MRI characteristics and surgery resection. According to their MRI features,we divided the tumors into three types： TypeⅠ： large cystic with small nodule; type Ⅱ： solid and cystic,Type Ⅲ： entity solid,and made different individualized plans to resect the tumors. Results 7 cases were large cystic with small nodule,5 cases were cystic and solid,and 4 cases were solid mass. 10 cases among them locate in the cerebellar hemispheres,2 cases in cerebellar vermis and 4 cases in medullary dorsal side,Their MRI characteristics were basicly consistent with intraoperative findings. All 16 cases were completely resection without serious complications and death. Conclusions The MRI classification of posterior fossa hemangioblastoma reflect the pathological morphology and blood supply,which help to make individualized preoperative surgical plan,reduce the risk of surgery decrease post-operated complications and improve the effect of the posterior fossa hemangioblastoma microsurgical treatment.