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目的 探讨颈髓髓内血管母细胞瘤的诊断与治疗。方法 分析 2 1例这类肿瘤患者的MRI表现 ,及其手术治疗的方法与结果。结果 这类肿瘤在MRI上可分为三型 :空洞型 ,肿瘤大小不等 ,且继发延、脊髓空洞 ;囊肿型 ,为囊内小的附壁结节 ;实体型 ,为巨大的实体性肿瘤。所有患者均经手术全切除肿瘤 ,并经病理证实为血管母细胞瘤。术后患者神经系统状态好转者 2 0例 ,加重 1例。结论 颈髓MRI能对颈髓髓内血管母细胞瘤作出定位、定性诊断 ,并可将其分型 ,以利选择不同的手术方法 ;诊断时 ,还需与胸廓出口综合征和颈椎病相鉴别。认为颈髓髓内、即使累及延髓的血管母细胞瘤宜行积极手术治疗 ;手术方法随肿瘤类型不同而各异 ,最为重要是 :需沿正确的界面分离 ,并应在离断供血动脉后切除肿瘤。
Objective To investigate the diagnosis and treatment of cervical intramedullary hemangioblastoma. Methods Twenty - one cases of these tumors were analyzed with MRI and the surgical methods and results. Results These tumors can be divided into three types on MRI: cavity type, tumor size range, and secondary delay, syringomyelia; cyst type, small intracapsular ciliated nodules; solid type, a huge substantive Tumor. All patients undergone total resection of the tumor and pathologically confirmed as hemangioblastoma. Postoperative patients with neurological improvement 20 cases, an increase of 1 case. Conclusion Cervical spinal cord MRI can locate and diagnose intramedullary hemangioblastoma in cervical intramedullary neoplasms, and can be divided into different types to facilitate the selection of different surgical methods. In diagnosis, cervical thoracic outlet syndrome and cervical spondylosis should be differentiated . It is considered that intramedullary marrow involvement of the medullary hemangioblastoma should be performed surgically. The method of operation varies with the type of tumor. The most important thing is that it needs to be separated along the correct interface and should be removed after the artery is severed Tumor.