颈髓髓内血管母细胞瘤的诊断与治疗(英文)

Diagnosis and treatment of intramedullary hemangioblastoma of cervical spinal cord

目的 探讨颈髓髓内血管母细胞瘤的诊断与治疗。方法 分析 2 1例这类肿瘤患者的MRI表现 ,及其手术治疗的方法与结果。结果 这类肿瘤在MRI上可分为三型 :空洞型 ,肿瘤大小不等 ,且继发延、脊髓空洞 ;囊肿型 ,为囊内小的附壁结节 ;实体型 ,为巨大的实体性肿瘤。所有患者均经手术全切除肿瘤 ,并经病理证实为血管母细胞瘤。术后患者神经系统状态好转者 2 0例 ,加重 1例。结论 颈髓MRI能对颈髓髓内血管母细胞瘤作出定位、定性诊断 ,并可将其分型 ,以利选择不同的手术方法 ;诊断时 ,还需与胸廓出口综合征和颈椎病相鉴别。认为颈髓髓内、即使累及延髓的血管母细胞瘤宜行积极手术治疗 ;手术方法随肿瘤类型不同而各异 ,最为重要是 :需沿正确的界面分离 ,并应在离断供血动脉后切除肿瘤。

OBJECTIVE: To investigate the diagnosis and surgical techniques of intramedullary hemangioblastoma of the cervical spinal cord. METHODS: MR imaging and the methods and results of surgery were analyzed in 21 patients. RESULTS: The tumors were divided into three types on MR imaging. Syringeal type, where the tumor varied in size and was accompanied by syringobulbia and syringomyelia; Cystic type, where the tumor presented as a cyst with a small mural node; and Solid type, where the tumor was revealed as a huge solid mass. All tumors were totally removed and diagnosis was confirmed by histological study. Post-operative neurological status was improved in 20 patients and aggravated in 1. CONCLUSIONS: The localization and the nature diagnosis of the tumor can be made by cervical MR imaging. Operative methods vary with tumor types. It is the most important that the tumor is dissected along the right interface and removed after devascularization.