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脑实质内外侧裂脑膜瘤的诊断与外科治疗

[Diagnosis and surgical treatment of intraparenchymal sylvian fissure meningioma].

作者信息

Zheng Jian, Wang Shuo, Zhao Ji-Zong, Cao Yong

机构信息

Department of Neurosurgery, Beijing Tiantan Hospital, Brijing 100050, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2009 Sep 8;89(33):2353-5.

Abstract

OBJECTIVE

To describe the characteristics of patients diagnosed with intraparenchymal sylvian meningioma at our department.

METHODS

A retrospective review was performed over 5 patients with intraparenchymal sylvian fissure meningioma confirmed by histopathology and receiving treatment at our department during January 1997 to September 2008.

RESULTS

The mean age was 19.4 years old and there were 3 males and 2 females. On CT scanning, intraparenchymal sylvian meningioma was iso- or slightly hyper-dense masses. On MR imaging, tumors showed iso- or hypo- intense signal on T1WI and hyperintense signal on T2WI. After contrast enhancement, T1-weighted images revealed well-demarcated enhancing masses and intimately associated with the middle cerebral artery and its branches in the sylvian fissure. All the patients underwent craniotomy.

CONCLUSION

As a rare disease with radiographic characteristics similar to those of general meningiomas, intraparenchymal sylvian fissure meningioma does not adhere to the dura matter but adhere to or even encase the middle cerebral artery and its branches in the sylvian fissure. All of the above have differential values. During the surgical procedures, a proper handling of tumor and encompassed main trunk of middle cerebral artery and its branches is crucial to patient prognosis.

摘要

目的

描述我院诊断为脑实质内外侧裂脑膜瘤患者的特征。

方法

对1997年1月至2008年9月期间在我院接受治疗、经组织病理学确诊为脑实质内外侧裂脑膜瘤的5例患者进行回顾性分析。

结果

平均年龄19.4岁,男性3例,女性2例。CT扫描显示,脑实质内外侧裂脑膜瘤为等密度或稍高密度肿块。磁共振成像(MR)显示,肿瘤在T1加权像(T1WI)上呈等信号或低信号,在T2加权像(T2WI)上呈高信号。增强扫描后,T1加权像显示边界清晰的强化肿块,与外侧裂内大脑中动脉及其分支关系密切。所有患者均接受了开颅手术。

结论

脑实质内外侧裂脑膜瘤是一种罕见疾病,其影像学特征与一般脑膜瘤相似,不附着于硬脑膜,而是附着于甚至包裹外侧裂内的大脑中动脉及其分支,上述特征均具有鉴别意义。在手术过程中,妥善处理肿瘤以及所累及的大脑中动脉主干及其分支对患者预后至关重要。

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