脑内海绵状血管瘤28例临床分析

Clinical analysis of 28 cases of intracerebral cavernous angiomas

目的 分析总结了脑内海绵状血管瘤的临床表现、影像学特点及治疗效果。方法 回顾分析10年间收治的经病理证实的28例脑内海绵状血管瘤。结果 本组平均病程为2.6年,头痛、呕吐、癫痫发作、局限性神经功能损害为脑内CA的主要临床表现;病理表现为由窦状扩张的畸形血管构成,其内无脑组织;CT典型表现为脑实质内类圆形或结节状稍高密度或混杂密度灶;MRI T_1W以等信号为主,T_2 W以高信号多见,部分可见瘤周环形低信号,无占位效应,无血管流空效应;DSA多表现为无特征的乏血管病变。治疗以手术切除为主。结论 脑内CA是生长缓慢的良性病变,目前以手术治疗为主,且效果较好。MRI是诊断脑内CA的最敏感的方法。

Objective To study the clinical manifestation, radiological features and the therapeutic efficacy of intracerebral cavernous angioma(CA). Methods Retrospective analysis of 28 cases of intracerebral CA treated in the last 10 years and diagnosed by pathology was done. Results The mean clinical course was 2. 6 years. Headache, vomiting, seisure and Icoal deficit were the main presentations of intracerebral CA. Pathologically, Intracerebral CAs are dilated sinusoidal spaces lined by a single layer of endothelium, usually without intervening brain tissue. In most patient,CT shows a roughly cirular or tubercular lesion located in the brain parenchyma, which shows slightly high or mixed density on the nonconstrast. MR T1W images largely appeared isointense signal. T2W showed high signal intensity mostly and a hypointense ring of T2W signal around intracerebral CA could be seen in some cases. There was no mass and draining vein effect. DSA almost always revealed an avascular area. Conclusions Intracerebral CA was a benign lesion which grow slowly. Microsurgery was the major treatment of intracerebral CA and the results of the management of these intracerebral CA patients were good. MR examination was the most sensitive methhod for diagnosis of intracerebral CA.