Huo Ran, Yu Qifeng, Xu Hongyuan, Wang Jie, Zhao Shaozhi, Weng Jiancong, Bai Xiudan, Jiao Yuming, Zhang Wenqian, He Qiheng, Wu Zhiyou, Liu Shaowen, Sun Yingfan, Ni Yang, Tang Jinyi, Wang Shuo, Cao Yong
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Road West, Beijing, 100070, Fengtai District, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Transl Stroke Res. 2025 Jan 31. doi: 10.1007/s12975-025-01333-5.
Our study aimed to investigate the factors associated with residual cavernous sinus extra-axial cavernous hemangiomas (ECHs) progression after surgery. This retrospective study consecutively included patients of cavernous sinus ECHs with incomplete lesion resection from February 2012 to January 2024. The progression of the lesions was defined as new lesions or a growth of residual lesion (≥ 10% increase in volume). Cox regression analysis was used to determine factors associated with residual lesion progression. Kaplan-Meier analysis was conducted to estimate the cumulative incidence of residual lesion progression. Sixty patients were included in this study. During the follow-up, there were 31 (51.7%) residual lesions underwent progression, whereas 29 (48.3%) patients were nonprogressive. Multivariate Cox analysis showed that the homogeneous enhancement lesion was correlated with the residual lesion progression (HR, 8.17 [95% CI, 1.03-64.58]; p = 0.046). Kaplan-Meier survival analysis indicated that the rate of homogeneous enhancement lesion progression (3.7 per 10 person-years) was significantly higher than that of the heterogeneous enhancement group (0.5 per 10 person-years; p = 0.019). Fourteen of the 31 patients with lesion progression underwent radiotherapy, and all of them experienced control over the progression of their lesions. This study found that end-of-treatment residual lesions are not rare in patients with cavernous sinus ECHs and the MRI feature is helpful to predict the progression of residual lesions.
我们的研究旨在调查与海绵窦轴外海绵状血管瘤（ECHs）术后残留病变进展相关的因素。这项回顾性研究连续纳入了2012年2月至2024年1月间海绵窦ECHs病变切除不完全的患者。病变进展定义为出现新病变或残留病变增大（体积增加≥10%）。采用Cox回归分析确定与残留病变进展相关的因素。进行Kaplan-Meier分析以估计残留病变进展的累积发生率。本研究共纳入60例患者。随访期间，31例（51.7%）残留病变出现进展，而29例（48.3%）患者无进展。多因素Cox分析显示，均匀强化病变与残留病变进展相关（HR，8.17 [95% CI，1.03 - 64.58]；p = 0.046）。Kaplan-Meier生存分析表明，均匀强化病变进展率（每10人年3.7例）显著高于不均匀强化组（每10人年0.5例；p = 0.019）。31例病变进展患者中有14例接受了放疗，所有患者的病变进展均得到控制。本研究发现，海绵窦ECHs患者治疗结束时的残留病变并不少见，MRI特征有助于预测残留病变的进展。
