Hanakita J, Handa H
No Shinkei Geka. 1984 Mar;12(4):445-50.
Before the application of CT scan, the exact identification of extracranial extension of brain tumors was difficult. In the present paper, neuroradiological findings of eight brain tumors with extracranial extension were reviewed. These eight cases were composed of two sphenoidal meningiomas, one CP angle meningioma, one CP angle neurofibroma, two pituitary adenomas, and two jugular foramen chemodectomas. After the first application of CT scan on May, 1976, 841 cases of primary intracranial tumors have been experienced in our clinic. So the incidence of brain tumors with extracranial extension was about 1%. The mean age of the patients was 51 years and all of the patients were females. In the neuroradiological examinations, plain skull films, tomograms, angiograms and CT scans were reviewed. Plain skull films and tomograms showed indirect signs of extracranial extension, such as destruction or hyperostosis of the skull and enlargement of the foramina. Direct signs of extracranial extension in the plain films were not obtained except in the pituitary adenomas, which extended into the paranasal sinuses and pharynx. Angiograms showed direct signs of extracranial extension, when remarkable tumor stain existed. Occlusion of the internal jugular vein suggested the extension of the tumor through the jugular foramen. In the cases without tumor stains, angiograms were useless to identify the extracranial portion of the tumor. CT scans were useful in all cases to detect extracranial extension. From the findings of CT scan, extracranial extensions of brain tumors were classified into four types. Extracranial extension with destruction of the skull. Extracranial extension with hyperostosis of the skull. Extracranial extension with both hyperostosis and destruction of the skull. Extracranial extension with enlargement of the skull foramina. To detect extracranial extension of brain tumors, enhanced coronal CT scan seemed most useful.
在CT扫描应用之前，准确识别脑肿瘤的颅外扩展很困难。本文回顾了8例有颅外扩展的脑肿瘤的神经放射学表现。这8例包括2例蝶骨脑膜瘤、1例桥小脑角脑膜瘤、1例桥小脑角神经纤维瘤、2例垂体腺瘤和2例颈静脉孔化学感受器瘤。自1976年5月首次应用CT扫描以来，我们诊所共诊治了841例原发性颅内肿瘤。因此，有颅外扩展的脑肿瘤的发生率约为1%。患者的平均年龄为51岁，均为女性。在神经放射学检查中，回顾了头颅平片、体层摄影、血管造影和CT扫描。头颅平片和体层摄影显示颅外扩展的间接征象，如颅骨破坏或骨质增生以及孔道扩大。除垂体腺瘤延伸至鼻窦和咽部外，平片中未获得颅外扩展的直接征象。血管造影显示有明显肿瘤染色时为颅外扩展的直接征象。颈内静脉闭塞提示肿瘤通过颈静脉孔扩展。在无肿瘤染色的病例中，血管造影对识别肿瘤的颅外部分无用。CT扫描在所有病例中均有助于检测颅外扩展。根据CT扫描结果，脑肿瘤的颅外扩展分为四种类型。颅骨破坏型颅外扩展。颅骨骨质增生型颅外扩展。颅骨骨质增生和破坏型颅外扩展。颅骨孔道扩大型颅外扩展。为检测脑肿瘤的颅外扩展，增强冠状位CT扫描似乎最有用。
