脊髓海绵状血管瘤的诊治特点

Diagnosis and treatment of spinal cavernous hemangioma

目的:探讨脊髓海绵状血管瘤的诊治方法和特点.方法:1991～2001年治疗脊髓海绵状血管瘤22例,均进行MRI检查,16例行全脊髓血管造影.全组均经后背正中直切口显微手术治疗.结果:22例均为单发,1例术前未能明确诊断,术后证实为海绵状血管瘤.颈段8例,颈胸段6例,胸段4例,腰段2例,圆锥马尾部位2例.MRI显示团块状短T1长T1信号,中间由点条状长T1短T2信号分隔,形成桑葚状混杂信号团,周边绕以低信号团,尤以T2WI显著.随访3个月～2年,全组均未见复发,12例术后功能明显恢复.结论:MRI是脊髓海绵状血管瘤术前最可靠的诊断方法.全脊髓血管造影可以排除其它脊髓血管畸形.显微手术切除是脊髓海绵状血管瘤的优选治疗方法,术中精细的显微操作是手术成功的关键.

Objective:To study the characteristic of diagnosis and treatment of spinal cavernous hemangioma.Method:During 1991~2001,22 spinal cavernous hemangiomas were treated in our department.All the 22 cases received MRI examination,16 cases received spinal DSA examination.22 cases of spinal cavernous hemangiomas were totally resected by transdorsal approaches.Result:Among the 22 cases,8 lesions located in the cervical segment of the spinal cord,6 in the cervical-thoracic segment,4 in the thoracic segment,2 in the lumbar segment and 2 in the thoracic-lumbar segment.The MRI characteristic was just like mulberry mixed signal lump,a black ring around the cavernoma indicates disturbances of susceptibility caused by the iron in hemosiderin.There was no any case of resuscitation after 3 months to 2 years follow-up.Conclusion:MRI is the most reliable method of diagnosis of spinal cavernous hemangiomas.DSA can differentiate other spinal AVM.Microsurgery is the best method of treatment of spinal cavernous hemangiomas.Excellent surgical skill the key point of success.