中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2012年
5期
504-508
,共5页
于洮%王光华%任晓辉%姜中利%张懋植%林松
于洮%王光華%任曉輝%薑中利%張懋植%林鬆
우조%왕광화%임효휘%강중리%장무식%림송
脑肿瘤%松果体肿瘤%诊断%治疗
腦腫瘤%鬆果體腫瘤%診斷%治療
뇌종류%송과체종류%진단%치료
Brain neoplasms%Pineatoma%Diagnosis%Therapy
目的 探讨松果体实质肿瘤的诊断和治疗方法.方法 回顾性分析35例松果体实质肿瘤患者(松果体细胞瘤10例,中分化松果体实质肿瘤13例,松果体母细胞瘤12例).CT及MRI示松果体区团块样肿物,松果体细胞瘤边界规则、清楚,增强均匀.恶性松果体实质肿瘤边界不清、分叶状,不均匀增强.手术选择Poppen入路16例,经胼胝体-穹窿间入路16例,幕下小脑上入路1例和三角区入路2例.结果 肿瘤全切除13例,近全切除16例,部分切除6例.术中多数肿瘤与周围组织有粘连.术后23例患者进行了放射治疗.随访7例患者因肿瘤复发死亡.中分化松果体实质肿瘤和松果体母细胞瘤的中位生存期分别为28.2个月和47.6个月.结论 术前影像学检查有助于判断良恶性肿瘤.松果体细胞瘤手术治疗效果良好.中分化松果体实质肿瘤和松果体母细胞瘤治疗首选手术联合放射治疗,但预后较差.
目的 探討鬆果體實質腫瘤的診斷和治療方法.方法 迴顧性分析35例鬆果體實質腫瘤患者(鬆果體細胞瘤10例,中分化鬆果體實質腫瘤13例,鬆果體母細胞瘤12例).CT及MRI示鬆果體區糰塊樣腫物,鬆果體細胞瘤邊界規則、清楚,增彊均勻.噁性鬆果體實質腫瘤邊界不清、分葉狀,不均勻增彊.手術選擇Poppen入路16例,經胼胝體-穹窿間入路16例,幕下小腦上入路1例和三角區入路2例.結果 腫瘤全切除13例,近全切除16例,部分切除6例.術中多數腫瘤與週圍組織有粘連.術後23例患者進行瞭放射治療.隨訪7例患者因腫瘤複髮死亡.中分化鬆果體實質腫瘤和鬆果體母細胞瘤的中位生存期分彆為28.2箇月和47.6箇月.結論 術前影像學檢查有助于判斷良噁性腫瘤.鬆果體細胞瘤手術治療效果良好.中分化鬆果體實質腫瘤和鬆果體母細胞瘤治療首選手術聯閤放射治療,但預後較差.
목적 탐토송과체실질종류적진단화치료방법.방법 회고성분석35례송과체실질종류환자(송과체세포류10례,중분화송과체실질종류13례,송과체모세포류12례).CT급MRI시송과체구단괴양종물,송과체세포류변계규칙、청초,증강균균.악성송과체실질종류변계불청、분협상,불균균증강.수술선택Poppen입로16례,경변지체-궁륭간입로16례,막하소뇌상입로1례화삼각구입로2례.결과 종류전절제13례,근전절제16례,부분절제6례.술중다수종류여주위조직유점련.술후23례환자진행료방사치료.수방7례환자인종류복발사망.중분화송과체실질종류화송과체모세포류적중위생존기분별위28.2개월화47.6개월.결론 술전영상학검사유조우판단량악성종류.송과체세포류수술치료효과량호.중분화송과체실질종류화송과체모세포류치료수선수술연합방사치료,단예후교차.
Objective Pineal parenchymal tumors are rare intracranial tumors.We studied the clinical features,neuro- radiology and pathology of pineal parenchymal tumors and discussed the treatment strategy.Methods There were 35 pineal parenchymal tumors patients (10 pineocytoma,13 pineal parenchymal tumor of intermediate differentiation,12 pineoblastoma) involved in this study.CT and MRI revealed pineocytoma to be round and have regular margins. Pineal paranchymal tumor of intermediate differentiation and pineoblastoma were lobular,irregular marginal and heterogenous enhancement.Poppen approach was performed in 16 cases,transcallosum approach in 16 cases,subtentorial -supracerebellar approach in 1 case and transtrigone lateral ventricle approach in 1 case.Results All of the tumors were surgically removed,including 13 totally removed,16 subtotally removed and 6 partially removed.23 patients received radiotherapy after operation.During the follow up there was 7 patients died because of tumor recurrence.Conclusions Pineocytoma patients have good survival prognosis after surgical treatment.Microsurgery combining with radiotherapy represents the most effective therapy for pineal parenchymal tumor of intermediate differentiation and pineoblastoma.Although these tumors have poor prognosis and more efforts should be made to improve the level of treatment.
