Rogers L R, Barnett G
Department of Neurology, Cleveland Clinic Foundation, OH 44195.
Neurology. 1991 Feb;41(2 ( Pt 1)):279-82. doi: 10.1212/wnl.41.2_part_1.279.
We performed percutaneous aspiration of 21 brain tumor cysts in 20 patients using the Ommaya reservoir system. Ages ranged from 3 to 70 years, median 48. Sixteen were primary tumors (12 anaplastic glioma, 2 craniopharyngioma, 1 oligodendroglioma, 1 brainstem glioma) and 4 were metastatic. Fourteen had the CT appearance of a true cyst and 7 a pseudocyst. We placed 18 catheters through twist drill holes via CT stereotactic guidance and 3 through burr holes via CT guidance and effectively aspirated 3 to 50 ml cyst fluid from 1 to 18 times in each patient. Postaspiration CT showed complete or significant reduction in cyst size in all patients in whom it was performed (18 after initial aspiration and 9 after subsequent aspirations). Asymptomatic intracyst hemorrhage occurred in 2 patients after cyst wall biopsy and catheter placement. There have been no other complications at follow-up of 4 to 114 weeks. In our experience, tumor cyst aspiration by the Ommaya reservoir system is as effective as percutaneous needle aspiration, but after catheter placement aspiration can be performed with minimal technical skill, avoiding repeated CT guidance required for needle aspiration of recurrent deep-seated cysts.
我们使用Ommaya储液囊系统对20例患者的21个脑肿瘤囊肿进行了经皮穿刺抽吸。年龄范围为3至70岁，中位数为48岁。16例为原发性肿瘤（12例间变性胶质瘤、2例颅咽管瘤、1例少突胶质细胞瘤、1例脑干胶质瘤），4例为转移性肿瘤。14例在CT上表现为真性囊肿，7例为假性囊肿。我们通过CT立体定向引导经钻颅孔置入18根导管，通过CT引导经颅骨钻孔置入3根导管，在每位患者中有效抽吸囊肿液3至50毫升，抽吸次数为1至18次。抽吸后CT显示，所有进行该检查的患者囊肿大小均完全或显著缩小（初次抽吸后18例，后续抽吸后9例）。2例患者在囊肿壁活检和导管置入后出现无症状性囊内出血。在4至114周的随访中未出现其他并发症。根据我们的经验，使用Ommaya储液囊系统进行肿瘤囊肿抽吸与经皮针吸一样有效，但在导管置入后，抽吸操作所需技术技能 minimal ，避免了对复发性深部囊肿进行针吸时所需的重复CT引导。
