CAJ | 학술논문

目的探讨脑CT静脉造影(CTV)对镰幕脑膜瘤手术方案的指导价值.方法选取25例镰幕脑膜瘤患者术前行脑CTV检查,在工作站重建二维和三维图像,对脑膜瘤进行分型并判断邻近静脉的狭窄程度和代偿情况,据此选择能够安全避开主要回流静脉的手术入路.结果根据镰幕脑膜瘤与邻近静脉(窦)关系及肿瘤生长方向,将镰幕脑膜瘤分为前、后、上、下和侧方5种类型.本组属前型者5例,后型4例,下型者3例,上型6例,侧方型7例.肿瘤与静脉(窦)的关系均与术中情况吻合,手术全切肿瘤19例,次全切除6例,主要的回流静脉均予保留.术后3例出现象限盲或偏盲,术后3个月随访时均完全恢复.结论 CTV可对镰幕脑膜瘤进行分型,有助于镰幕脑膜瘤手术入路的选择.
목적 탐토뇌CT정맥조영(CTV)대렴막뇌막류수술방안적지도개치.방법 선취25례렴막뇌막류환자술전행뇌CTV검사,재공작참중건이유화삼유도상,대뇌막류진행분형병판단린근정맥적협착정도화대상정황,거차선택능구안전피개주요회류정맥적수술입로.결과 근거렴막뇌막류여린근정맥(두)관계급종류생장방향,장렴막뇌막류분위전、후、상、하화측방5충류형.본조속전형자5례,후형4례,하형자3례,상형6례,측방형7례.종류여정맥(두)적관계균여술중정황문합,수술전절종류19례,차전절제6례,주요적회류정맥균여보류.술후3례출현상한맹혹편맹,술후3개월수방시균완전회복.결론 CTV가대렴막뇌막류진행분형,유조우렴막뇌막류수술입로적선택.
Objective To explore the value of CT venography in the surgical treatment of falcotentorial junction meningiomas. Methods CT venography was carried out in 25 patients with falcotentorial junction meningiomas. 2-D and 3-D images were reformatted at the workstation. The classification and relationship between the tumors and veins were determined, and the degree of venous stenosis and collateral were assessed. The safe surgical pathway was chosen to avoid the injury of main draining vein. Results Falcotentorial junction meningiomas were divided into 5 types according to the relationship between the tumors and veins and the direction of the tumors. There were 5 cases of forward type, 4 cases of backward type, 3 cases of inferior type, 6 cases of superior type and 7 cases of lateral type in this group. The relationship between tumors and veins was accordant with the findings in surgery. Of all 25 cases, 19 underwent total removal, 6 underwent subtotal removal and all of the main driving veins were reserved. There were 3 cases of quadrantanopsia or hemianopsia after the operation, and all of them recovered after 3 months of follow-up. Conclusion CTV technique can classify the falcotentorial junction meningioma and is helpful for choosing the appropriate surgical approaches.