侧脑室脑膜瘤的影像学特征与手术治疗预后的相关性

Correlation between Imaging Features of Lateral Ventricle Meningioma and Prognosis of Surgical Treatment

目的探讨侧脑室脑膜瘤的影像学特征与手术治疗预后的相关性。方法选取侧脑室脑膜瘤患者80例,所有患者都进行常规CT扫描与增强CT扫描,记录脑血流量(CBF)、脑血容量(CBV)及平均通过时间(MTT);所有患者都给予显微手术治疗,记录手术预后。结果侧脑室脑膜瘤CT影像学特征主要表现为形态卵圆形,病灶内部密度大,伴随有豆状核钙化;患侧区的CBF和CBV值都明显低于健侧区,而MTT值明显高于健侧区,对比差异都有统计学意义(P<0.05)。在80例患者中,采用肿瘤全切除70例,10例患者采取次全切,都顺利完成手术。术后患者出现神经功能障碍者12例,发生率为15.0%;综合疗效:痊愈60例,轻度功能障碍10例,中度功能障碍6例,植物状态3例,死亡1例,有效率为87.5%。Pearson分析显示80例患者的CBF和CBV值与预后神经功能障碍、有效率都存在明显负相关性(P<0.05),而MTT与预后神经功能障碍、有效率都存在明显正相关性(P<0.05)。结论 CT检查能够明确侧脑室脑膜瘤的性质与血供状态,显微手术治疗能取得比较好的效果,CT影像学特征对于判断患者预后有很好的作用。

Objective To investigate the correlation between imaging features of lateral ventricle meningioma and prognosis of surgical treatment. Methods 80 patients with lateral ventricle were selected,all patients were underwent routine CT scan and enhanced CT scan,recorded the cerebral blood flow（ CBF）,cerebral blood volume（ CBV） and mean transit time（ MTT）; all patients were given the micro surgical treatment,the prognosis were recorded. Results The CT imaging features of lateral ventricle meningioma were mainly manifested as oval,internal density and large lesions associated with ipsilateral lentiform nucleus calcification; the CBF and CBV values in the affected area were significantly lower than the contralateral area,while the MTT value was significantly higher than that of the contralateral area,the difference was all statistically significant（ P 〈 0. 05）. In the 80 patients,there were 70 patients underwent total tumor resection,and 10 patients underwent subtotal resection,and all were successfully performed. There were 12 patients with neurological dysfunction after operation,the incidence rate was 15. 0%,comprehensive efficacy： 60 cases were cured,10 cases were mild dysfunction,6 cases were moderate dysfunction,3 cases were vegetative state,1 case were died,the effective rate was 87. 5%. Pearson analysis showed that the CBF and CBV were negatively correlated to the prognosis of nerve dysfunction and efficiency in the 80 patients（ P 〈 0. 05）,and the MTT were positively correlated to the prognosis of nerve dysfunction and efficiency（ P 〈 0. 05）. Conclusion CT examination can make clear the nature and blood supply status of lateral ventricles meningioma,and the microsurgical treatment can achieve better results. CT imaging features has good effect in judging the prognosis of patients.