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[脊髓海绵状血管畸形的显微外科治疗]

[Microsurgical treatment of spinal cavernous malformation].

作者信息

Gu Xiao-Chun, Yang Yu-Ming, Yuan Qing-Guo, Sha Cheng, Jiang Hong-Zhi

机构信息

Department of Neurosurgery, Beijing Hospital, Beijing 100730, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2008 Jun 17;88(23):1621-3.

Abstract

OBJECTIVE

To investigate the characteristics of clinical manifestations, diagnostic imaging, pathology, and microsurgical treatment of spinal cavernous malformation.

METHODS

The clinical data of 28 patients with spinal cavernous malformation undergoing total resection through posterior approach during 1991-2006, all receiving MRI examination and 22 also receiving spinal DSA examination, were analyzed.

RESULTS

Among the 28 cases, 8 lesions were located in the cervical segment of the spinal cord; 12 lesions in the cervical-thoracic segment; 4 lesions in the thoracic segment; 2 in the lumbar segment, and 2 in the thoraco-lumbar segment. The MRI images looked like mulberry; a black ring around the cavernoma was indicated. The spinal cord tissues around the lesion were obviously stained by the deposited hemosiderin. Follow-up of 3 months to 6 year showed no recurrence.

CONCLUSION

MRI is the most reliable method for diagnosis of spinal cavernous malformation and surgical resection is the best treatment method. The key of success is meticulous surgical techniques. DSA helps differentiate spinal cavernous malformation from other arterio-venous malformations.

摘要

目的

探讨脊髓海绵状血管畸形的临床表现、诊断性影像学特征、病理学特点及显微外科治疗方法。

方法

分析1991年至2006年间28例行后路全切除的脊髓海绵状血管畸形患者的临床资料,所有患者均接受了MRI检查,22例还接受了脊髓DSA检查。

结果

28例中,8个病变位于脊髓颈段;12个病变位于颈胸段;4个病变位于胸段;2个位于腰段,2个位于胸腰段。MRI图像呈桑葚状;海绵状血管瘤周围可见黑色环。病变周围脊髓组织被沉积的含铁血黄素明显染色。随访3个月至6年未见复发。

结论

MRI是诊断脊髓海绵状血管畸形最可靠的方法,手术切除是最佳治疗方法。成功的关键是精细的手术技巧。DSA有助于鉴别脊髓海绵状血管畸形与其他动静脉畸形。

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