摘要
目的评价经动脉栓塞术(TAE)对巨大富血供脑膜瘤术前栓塞的临床意义。方法 32例巨大富血供脑膜瘤患者(男性18例,女性14例,年龄38～65岁,平均56.5岁)为确认肿瘤供血动脉,先经选择性血管造影(DSA),随后又经术前TAE。全部TAE操作是采用Seldinger技术将150～300μm的聚乙烯醇(PVA)微粒或海藻酸钠(KMG)微球超选择地注入病灶血管床及供血动脉完成。对全部患者获自DSA与TAE的资料进行了回顾性分析。结果 DSA证实,在32例脑膜瘤患者的肿瘤供血动脉中,主要为颈外动脉分支供血者见于22例,颈内、外动脉供血各占50%者6例,颈内动脉供血者占90%以上者4例;脑膜瘤供血动脉大部分栓塞者15例,部分栓塞10例,未栓塞7例。在肿瘤大部分栓塞患者的切除术中,出血量明显减少,手术时间显著缩短,肿瘤易被彻底切除。未发生与栓塞操作有关的严重并发症。结论脑膜瘤术前介入栓塞能减少术中出血,降低手术难度,可作为富血供脑膜瘤切除术前的一项重要的、常规性辅助措施。
Objective To evaluate the clinical significance of preoperative transarterial embolization（TAE） for the surgical resection of large-hypervascular meningiomas（LHMs）.Methods Thirty-two patients（18 men,14 women,aged 38-65 years;mean age,56.5 years） with LHMs initially underwent selectively digital subtraction angiography（DSA） to determine the arteries feeding the tumors and subse quently underwent preoperative TAE.All TAE procedures were performed using Seldinger technique with 150-300 μm PVA or KMG which were superselectively injected into the lesion vessel bed and tumor blood-supply arteries.The both data acquired from DSA and TAE were retrospectively analyzed in all patients.Results DSA demonstrated that 22 patients whose meningiomas were exclusively supplied by external carotid artery（ECA） branches,6 patients whose meningiomaas were dually supplied by ECA and internal carotid artery（ICA）（50% each）,and 4 patients whose meningiomas were predominantly supplied by ICA（over 90%）;the blood-supply of the tumor in 15 patients was blocked,and partial occlusion through embolization was performed in 10 patients,while non-occlusion through embolization was only in 7 patients.In patients whose feeding arteries were blocked,the intraoperative bleeding was obviously reduced,the operation time was greatly shortened,and complete resection of the tumor was mare easy.There were no severe complications related to the procedure.Conclusion Preoperative TAE of meningiomas can reduce intraoperative bleeding,shorten operation times,decrease operation difficulty,so that it should be taken as an important and conventional procedure before surgical resection of meningiomas with rich blood-supply.
出处
《实用医学影像杂志》
2010年第4期263-266,共4页
Journal of Practical Medical Imaging
关键词
富血供脑膜瘤
数字减影血管造影
经动脉栓塞
Meningioma
hypervascular
Digital subtraction angiography
Transarterial embolization
