枕骨大孔区肿瘤的MRI诊断及显微外科治疗

MRI diagnosis and microsurgical therapy for foramen magnum tumor

目的探讨枕骨大孔区肿瘤的MRI诊断、类别和显微外科治疗方法。方法回顾分析MRI诊断和显微手术治疗51例枕骨大孔区肿瘤,根据肿瘤的MRI及类别选择手术入路,经枕下后正中入路手术切除41例,经枕下远外侧入路手术切除10例。结果肿瘤全切除37例(72.5%),次全切除13例,部分切除l例。临床症状改善者40例,保持原有症状者5例,症状较术前加重4例,术后死亡2例。术后随访到45例,随访期内复发3例。结论枕骨大孔区肿瘤种类及表现差异性大,MRI检查可提供准确的定位和诊断;根据MRI成像特点选择恰当的手术入路和采用显微外科手术切除肿瘤可获得良好的临床效果。

Objective To explore MRI diagnosis,category and microsurgical therapy for magnum foramen tumor. Methods A retrospective analysis was performed in which 51 cases with magnum foramen tumor were diagnosed by MRI and received mi- erosurgical therapy. The surgical approaches were decided based on tumor＇s MRI features and category. Sub-occipital posterior midline approach was applied to 41 cases and far lateral sub-occipital approach was applied to 10 cases. Results 37 cases under- went total tumor removal （72.5 %）, 13 cases underwent subtotal tumor removal and one case underwent partial removal. Improved symptoms occurred in 40 cases,the maintained original symptoms occurred in 5 cases,aggravated symptoms occurred in 4 cases and death occurred in one case. A total of 45 cases had integrated follow-up data,among whom 3 cases recurred. Conclusion The kinds and the manifestations of magnum foramen tumors are so different, and MRI examination can give correct location and diag- nosis. According to the characteristics of MRI, the appropriate surgical approach and microsurgical resection can have a good clinical effect.