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目的探讨脑(脊髓)内外海绵状血管瘤(CA)的影像学特点及治疗方法。方法脑内CA 13例,分别位于脑皮层深部、海马、外侧裂Broca氏区、中央前回、后回、丘脑深部、桥脑及小脑半球；胸髓内CA 3例；位于海绵窦、鞍旁颅中窝的脑(轴)外CA 2例；髓外(T_(12))CA 1例。所有病例均行CT、MRI检查并接受显微外科手术治疗。结果脑(脊髓)内CA在MRI的T1、T2像上,病变周围可有典型的含铁血黄素黑环征；脑(脊髓)外CA的CT、MRI表现不具特征性。所有脑(脊髓)内CA在显微镜下(部分病例使用立体定向配合)获得全切；因轴外CA血供异常丰富,只作部分切除。结论MRI对于脑(脊髓)内CA具有诊断意义,对于反复出血病例宜争取显微手术全切；因轴外CA术中出血凶猛,应慎重决定其治疗方案。
Objective To investigate the imaging characteristics and treatment of cavernous hemangiomas (CA) in the brain (spinal cord). Methods CA 13 cases were located in the deep cortex, the hippocampus, the lateral cleft Broca’s area, the central anterior and posterior gyrus, the deep thalamus, the pons and the cerebellar hemisphere. There were 3 CA in the thoracic cavity and 3 cavernous sinus, There were 2 cases of CA outside the brain (axis) and 1 case of extramedullary (T_ (12) CA). All cases underwent CT, MRI examination and microsurgical treatment. Results CA in the brain (spinal cord) on the MRI T1 and T2 images, the lesions may have a typical hemosiderosis around the black ring; brain (spinal cord) outside the CT CT, MRI showed no characteristic. All of the brains (spinal cord) CA under the microscope (in some cases the use of stereotactic) to obtain full cut; due to abnormal extracapsular CA blood supply, only partial resection. Conclusions MRI is of diagnostic significance for intracerebral CA, and for microsurgical resections, microsurgical resection should be performed. Due to severe intraoperative bleeding in CA, caution should be taken for the treatment of CA.