目的:硬膜内毛细血管瘤是一种病因不明的罕见疾病。虽然硬膜内毛细血管瘤是良性的,它们表现出显著的增殖活性,其临床意义不可低估。
方法:我们报告了一系列脊髓硬膜内毛细血管血管瘤的特征,手术管理,和结果。
方法:对18例连续接受显微外科治疗的患者进行回顾性分析。记录每个病例的患者特征,包括出现症状,影像学发现,神经状态,进行的外科手术和随访。
结果:男性11例(61.1%),女性7例(38.9%),年龄从25岁到62岁不等。胸椎是最常见的病变部位,占病例总数的77.8%(14/18)。9个肿瘤被确定为硬膜内髓外,3肿瘤为髓内,和2个肿瘤作为髓外和髓内。还有4例位于马尾的肿瘤。临床表现包括背痛,感觉缺陷,无力和步态共济失调,症状持续时间为1至12个月。在T1加权图像上,病变与脊髓呈低信号或等强度,在T2加权图像上呈高强度,并在造影剂注射后显示出强烈的增强。所有患者均接受手术治疗,术后无明显并发症。术后,患者平均随访44个月。随访显示,大多数患者的神经功能得到了显着改善,无复发病例。
结论:手术切除通常是治疗脊髓硬膜内毛细血管瘤的首选方法。完全切除可以减轻脊髓压迫并最大程度地减少复发的风险。
OBJECTIVE: Intradural capillary hemangioma is a rare condition with unclear etiology. Although intradural capillary hemangiomas are benign, they exhibit significant proliferative activity, and their clinical significance should not be underestimated.
METHODS: We report a series of spinal intradural capillary hemangiomas to illustrate the characteristics, surgical management, and outcomes.
METHODS: A total of 18 consecutive patients who underwent microsurgical treatment were retrospectively reviewed. Patient characteristics were recorded in each case, including presenting symptoms, imaging findings, neurologic status, a surgical procedure performed and follow-up.
RESULTS: There were 11(61.1 %) male and 7(38.9 %) female patients, with the ages ranging from 25 to 62 years. The thoracic spine was the most commonly affected site, accounting for 77.8 % (14/18) of the cases. 9 tumors were identified as intradural extramedullary, 3 tumors as intramedullary, and 2 tumors as both extramedullary and intramedullary. There were also 4 cases of tumors localized to the cauda equina. Clinical presentations included back pain, sensory deficits, weakness and gait ataxia with a duration of symptoms ranging from 1 to 12 months. The lesion was hypointense or isointense with the spinal cord on T1- weighted images and hyperintense on T2-weighted images and showed intense enhancement after contrast medium injection. All patients underwent surgical treatment, and no significant postoperative complications were observed. Postoperatively, patients were followed up for an average of 44 months. Follow-up showed that the majority of patients experienced significant improvement in neurological function, with no cases of recurrence.
CONCLUSIONS: Surgical resection is typically the preferred method for treating spinal intradural capillary hemangiomas. Complete resection can relieve spinal cord compression and minimize the risk of recurrence.