双源CTA在蝶骨嵴脑膜瘤术前检查的应用价值

Application of dual source CTA in the preoperative examination of the sphenoid ridge meningioma

目的探讨双源CTA在蝶骨嵴脑膜瘤术前检查的应用价值。方法选取2009年1月至2016年3月在本院治疗的蝶骨嵴脑膜瘤患者23例,对双源CTA检查结果进行分析,重建肿瘤和颅底血管及骨质图像。结果 CTA图像可清晰显示Willis动脉环,容积再现法图像立体感强,对于肿瘤与周围血管结构毗邻三维立体关系显示效果最好,可以提供直观的观察,清晰显示肿瘤与周围大血管间的空间关系,但成像有时受到颅底骨质影响,部分血管细节显示不清;在瘤体大小和瘤颈宽度测量方面,最大密度投影(MIP)、多平面重建(MPR)、容积再现(VR)和数字减影血管造影(DSA)成像技术之间差异无统计学意义(P=0.672和0.728,P>0.05);在瘤体形态和瘤体三维关系方面,DSA图像评分低于VR和MIP(P<0.05),瘤体光滑度方面,VR图像评分高于MIP和DSA(P<0.05),在显示级别方面,DSA图像评分高于VR和MIP(P<0.05),总体质量方面,VR、MIP和DSA图像评分差异有统计学意义(P<0.05),其中VR图像评分最高,MIP次之。结论双源CTA在蝶骨嵴脑膜瘤术前检查中,可提供脑膜瘤血供情况以及与毗邻血管的三维空间关系,为蝶骨嵴脑膜瘤手术方案提供指导意见。

Objective To explore the application value of dual source CTA in the preoperative examinationof the sphenoid ridge meningioma. Method From 2009 January to 2016 March in our hospital treatment of sphenoidridge meningioma in 23 patients,the dual source CTA examination results were analyzed, and the reconstruction of tumorand skull base blood vessels and bone image. Results CTA images can clearly show the arterial circle of Willis,volume rendering image three-dimensional sense of strong, for the tumor and surrounding vascular structures adjacentto the three-dimensional relationship the best display,that can provide the intuitive observation, clearly show the spatialrelationship between tumor and surrounding large vessels between, but sometimes imaging by the skull base boneimpact, part of vessel details not clear;The tumor size and tumor neck width measurement, no statistically significantdifferences between MIP, MPR, VR and DSA imaging( P=0.672 and 0.728,P>0.05);The tumor morphology andtumor three-dimensional relations, DSA image score less than VR and MIP( P<0.05), tumor body smoothness, VRimage score higher than that of MIP and DSA( P<0.05), in display level, DSA image score higher than that of VR andMIP( P<0.05), overall quality , VR, MIP and DSA image score difference had statistically significant(P<0.05),in which VR image scores were the highest, followed by MIP. Conclusion Dual source CTA in the sphenoid ridgemeningioma preoperative examination, can provide meningioma blood supply and three-dimensional space adjacent tothe vascular relationship, provide guidance for sphenoid ridge meningioma operation scheme.