320排CT动态血管成像联合双时相CTA对颅底脑膜瘤术前评估

Preoperative assessment of related anatomic structures of skull base meningioma using dual-phase merging 3 dimension-CT angiography combined with time-resolved CT angiography

目的探讨双时相融合的3D-CTA联合4D-CTA对颅底脑膜瘤的评估价值。方法收集18例颅底脑膜瘤患者,采用动态容积增强扫描技术。影像资料分为A组和B组。A组仅使用双时相融合3D-CTA技术,B组同时使用双时相融合3D-CTA和4D-CTA。评估内容包括肿瘤大小、脑膜瘤供血分型、肿瘤与颅骨和旁路血管的关系。结果两组对肿瘤前后径、左右径和脑膜瘤供血分型的差异无统计学意义(P>0.05),A、B两组评估的肿瘤上下径分别为(29.50±10.90)mm、(29.96±10.91)mm,差异具有统计学意义(t=-3.379,P<0.05)。B组评估肿瘤与颅骨和旁路动脉关系的手术符合率均高于A组,但肿瘤与颅骨关系的评估差异没有统计学意义(P=0.104);A、B两组评估肿瘤与旁路动脉关系的手术符合率分别为66.67%(18/27)、92.59%(25/27),差异具有统计学意义(P=0.039)。结论双时相融合的3D-CTA联合4D-CTA双后处理技术能完善颅底脑膜瘤术前解剖信息。

Objective To explore the clinical role of combination of 3D-CTA and 4D-CTA in preoperative skull base meningioma.Methods 18 patients with skull base meningioma were enrolled in this work.CTA data setting was split into two groups.In group A,the post-processing model of 3D-CTA with integrated dual phase volume data was implied.In group B,combination of 3D-CTA and 4D-CTA was used.We evaluated contents included the size of neoplasm,feeding blood type and the correlation of neoplasm to skull bone and bypass arteries.Results No statistically differences was found in tumor size of anterioposterior and lateral dimensions,and feeding artery type between two groups(all P values>0.05).Craniocaudal dimension of group A and group B was(29.50±10.90)mm,(29.96±10.91)mm respectively,a statistically significant difference was shown(t=-3.378,P<0.05).There was no statistically significant difference in the ratio matched the operative determination of correlation of tumor to skull bone between two groups(P=0.104).The ratio matched the operative determination of correlation of tumor to bypass arteries in 18 of 27 branches(66.67%)of group B was higher than that in 25 of 27 branches(92.59%)of group A.Conclusion The postprocessing model of 3D-CTA merging dual phases integrated 4D-CTA can develop more preoperative anatomical information concerning skull base meningioma.