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目的探讨儿童颅骨膜血窦的临床特点,影像学诊断、治疗与疗效。方法回顾性分析本科2007年7月-2011年7月收治的27例颅骨膜血窦病例的临床资料。本组病例术前均行头颅CT三维成像或头颅CT血管造影三维成像,清楚显示病灶内异常血管团与颅内静脉窦相通,病灶下方存在不同程度的骨质缺损。治疗方法以手术为主,目的在于切除异常血管团,离断交通静脉,封堵缺损骨孔。结果本组病例共手术治疗23例,切除病灶25处,手术均获成功,未出现术中大出血、颅内静脉栓塞等并发症。术后21例症状消失,2例好转。术后随访6个月～3 a,无复发,复查CT大部分骨孔愈合。结论颅骨膜血窦是一种少见的静脉异常,是沟通颅外静脉和颅内静脉的无肌层静脉血管团,多见于儿童。临床常表现为与体位改变有关的非搏动性可回复的头皮软组织肿块。诊断主要依靠CT或头颅CT血管造影三维成像。治疗以手术切除为主,亦可血管内栓塞。术后效果满意。
Objective To investigate the clinical features, imaging diagnosis, treatment and curative effect of children skull membrane sinus. Methods The clinical data of 27 cases of skull base sinusoids admitted to our hospital from July 2007 to July 2011 were analyzed retrospectively. This group of patients underwent three-dimensional imaging of cranial CT or cranial CT angiography preoperatively, clearly shows abnormal blood vessels within the lesion communicating with the intracranial sinus, there are different degrees of bone defect below the lesion. The main treatment is surgery, the purpose is to remove abnormal blood vessels, off traffic veins, blocking the defect of bone. Results In this group, 23 cases were treated surgically and 25 cases were excised. All the surgeries were successful. There were no intraoperative bleeding, intracranial venous thrombosis and other complications. After 21 cases of symptoms disappeared, 2 cases improved. All the patients were followed up for 6 months to 3 years. No recurrence was found. Most of the holes in CT were healed. Conclusion Skull sinusoid is a rare venous anomaly, is the non-myenteric venous vascular mass communicating with the extracranial and intracranial veins, more common in children. Clinical manifestations often associated with changes in position non-pulsating recoverable scalp soft tissue mass. The diagnosis mainly depends on CT or CT angiography three-dimensional imaging. Surgical resection-based, but also intravascular embolization. Satisfactory results.