桥小脑角区表皮样囊肿的MRI分型诊断

目的：分析桥小脑角区表皮样囊肿的MRI表现并对其生长和蔓延方式进行分型诊断。方法：收集我院经手术病理证实的表皮样囊肿19例MRI检查。结果：19例桥小脑角区表皮样囊肿呈多种生长蔓延方式：脑池内塑型生长型、局限性生长型、鞍上蔓延型、鞍旁蔓延型、骑跨型。结论：桥小脑角区表皮样囊肿的MRI分型诊断与临床症状间有密切的联系，有助于鏊别诊断和指导手术治疗。     

MRI诊断桥小脑角区肿瘤196例分析

目的：评价MRI在桥小脑角区肿瘤中的诊断价值。方法：对196例经手术病理证实的桥小脑角区肿瘤患者MRI资料进行分析。结果：196例中听神经瘤86例，脑膜瘤38例，三叉神经瘤25例，表皮样囊肿23例，星形细胞瘤16例及颈静脉球瘤11例。结论：MRI能较好的显示桥小脑角区肿瘤，提高其诊断正确率。     

显微手术切除桥小脑角巨大表皮样囊肿六例体会

目的 :报道显微手术切除桥小脑角表皮样囊肿的手术体会。方法 :分析 6例桥小脑角巨大表皮样囊肿的临床资料和CT、MRI影像的特征性表现 ,分析其手术方法、手术结果、和术后并发症等。结果 :肿瘤全切除 5例 ,近全切除 1例 ,无手术死亡 ,3例术后症状全部消失 ,1例并发无菌性脑膜炎     

常见CPA区占位性病变的影像学特征分析

目的:总结分析40例常见桥小脑角区占位性病变的CT及MRI表现与特征,提高对桥小脑角区占位性病变的认识。材料与方法:对我院40例经临床或手术病理证实的桥小脑角区占位性病变的回顾性分析,15例行CT检查,40例均行MRI平扫及增强检查。结果:40例中听神经瘤28例,脑膜瘤8例,表皮样囊肿4例。均有各自特征性的CT和MRI表现,本组CT定位、定性准确率为70%、60%,MRI为100%、99%。结论:MRI是检查桥小脑角区占位性病变的首选方法,对桥小脑角区占位性病变诊断及鉴别诊断有重要价值。     

颅内表皮样囊肿的MRI诊断（附15例报告）

目的分析颅内表皮样囊肿的MRI表现。方法收集经手术嫡理证实的颅内表皮样囊肿15例，重点分析肿瘤的好发部位、大小形态及MRI扫描与增强扫描的信号特点。结果在本组嫡例中，桥小脑角区8例，鞍旁2例，斜坡区2例，枕骨1例，侧脑室三角部、第四脑室各1例。肿瘤在T1加权像上呈不均匀低信号，T2加权像、FLAIR图像上呈不均匀高信号，所有病例均行增强扫描，肿瘤均无强化。结论典型的颅内表皮样囊肿的MRI表现具有特征性，MRI检查可以作出准确诊断，并能与其他类似的颅内囊性病变相鉴别。     

颅内表皮样囊肿的影像学诊断

目的：评价颅内表皮样囊肿的影像学特征。方法：回顾性收集16例经手术与病理证实的表皮样囊肿。男11例,女5例,年龄29-56岁,平均年龄45岁;行CT平扫与增强检查4例,行MRI平扫与增强检查6例,同时行CT与MRI检查6例。结果：肿瘤发生于桥小脑角区5例,鞍上区4例,鞍旁区3例,四脑室2例,小脑蚓部和小脑延髓池各1例。CT平扫肿瘤呈脑脊液样低密度,大多形态不规则,少数呈圆形、卵圆形,均有不同程度占位效应,增强后均无强化。MRI检查,大多数类似脑脊液样信号,T1WI呈现低信号,T2WI呈高信号,少数在T1WI上呈高信号或混杂信号。结论：CT与MRI诊断表皮样囊肿均有重要价值,MRI显示表皮样囊肿优于CT。     

小脑桥脑角表皮样囊肿的显微外科治疗

目的：应用显微外科技术切除12例小脑桥脑角表皮样囊肿。方法：所有病例经枕下乙状窦后入路，术中根据四个间隙，从囊内分块切除肿瘤，最后切除肿瘤，对于粘连紧密者宁可残留小片组织，以免术后出现严重并发症，另外，术中应用激素冲洗及术后应用激素治疗，腰穿放脑脊液可以防止无菌性脑膜炎的发生。结果：12例小脑桥脑脑角表皮样囊肿全切除8例（66．7％），仅残留小片包膜4例（33．3％），术后有2例轻度面瘫，无严重并发症。结论：应用显微外科技术对小脑桥脑角表皮样囊肿大部分均可做到全切。     

桥脑小脑角胆脂瘤患者围术期的护理

胆脂瘤也称表皮样囊肿，肿瘤为在胚胎晚期继发性脑细胞形成时，将表皮带入导致。囊肿缺乏血管，包膜菲薄，内部常含有脂肪胆固醇结晶。胆脂瘤上表皮层表面翻向囊内，不断有细胞角化脱屑形成新的囊肿内容，导致肿瘤逐渐增大。胆脂瘤可发生于颅内各个部位，但临床多见于桥脑小脑角区。该部位毗邻重要的神经血管，且能沿着各种间隙生长，给手术的彻底切除及术后护理带来困难。2000年10月至2007年2月我院共手术切除桥脑小脑角胆脂瘤22例，经过手术前的充分准备及术后观察及护理，效果满意。     

MRI对桥小脑角脑膜瘤的诊断价值(附15例报告)

目的：分析桥小脑角脑膜瘤的MRI表现,提高对桥小脑角区脑膜瘤的MRI诊断准确率。材料与方法：搜集了一组经华山医院及本院手术病理证实的桥小脑角区脑膜瘤15例,全部行MRI平扫及增强。结果：TWI上8例与脑实质相近信号,占总病例53．3％,4例稍低于脑实质信号,占总病例的26．7％,3例以不均匀混杂信号显示,3例呈高低混杂信号。结论：MRI在桥小脑角脑膜瘤的定位、定性及鉴别诊断中有重要价值。     

桥脑小脑角区肿瘤96例磁共振诊断分析

目的 探讨桥脑小脑角区常见肿瘤的特征性MRI表现,以提高桥小脑角区肿瘤的影像诊断准确率.方法 回顾性分析96例经手术和病理证实的桥脑小脑角区肿瘤,其中听神经瘤55例,脑膜瘤20例,胆脂瘤9例,三叉神经瘤鞘瘤7例,海绵状血管瘤3例,蛛网膜囊肿2例.均行增强MRI扫描,总结MRI表现特征.结果 发生于桥脑小脑角区的肿瘤听神经瘤占首位,其次为脑膜瘤、胆脂瘤、三叉神经鞘瘤、海绵状血管瘤、蛛网膜囊肿等,该区肿瘤大多具有较特征性的影像学表现,术前定位准确率100%,定性准确率为94.7%.结论 MRI是检查桥脑小脑角区肿瘤的首选检查方法,对桥脑小脑角区肿瘤的诊断和鉴别诊断具有重要价值.

Abstract：

Objective To improve the preoperative diagnosis accuracy of cerebellopontine angle tumors through analyzing MRI findings. Methods Ninety-six cases with cerebellopontine angle tumors, confirmed by pathology and surgery, were collected and underwent MRI scan plus enhanced MRI. Among the 96 capes, we observed acoustic neurinoma in 55 cases, meningioma in 20 cases, cholesteatoma in 9 cases, trigeminal neuroma in 7 cases,cavernous hemangioma in 3 cases,arachnoid cyst in 2 cases. The MRI characteristics of all cases were analyzed retrospectively. Results The chief type of tumor happened in the cerebellopontine angle zone was acoustic neurinoma,followed in order by meningioma,cholesteatoma,trigeminal neuroma,cavernous hemangioma and arachnoid cyst. The accuracy of preoperative localization and qualitative diagnosis were 100% and 94.7%respectively.Conclusion MRI has a high value in the diagnosis and differential diagnosis of cerebellopontine angle tumors,which can be used as a preferred preoperative examination method in cerebellopontine angle tumors.     

Magnetic resonance imaging and proton magnetic resonance spectroscopy of intracranial epidermoid tumors

Intracranial epidermoid tumors or cysts are considered benign lesions. Differentiation of epidermoid tumors from arachnoid cysts is important for appropriate patient care because the treatment is different for each lesion. Arachnoid cysts can appear very similar to epidermoid tumors on computed tomography (CT). Epidermoid tumors can grow in the cerebellopontine angle (CPA) cistern, the most common location of these lesions, resulting in trigeminal neuralgia and facial paralysis. Treatment for epidermoid tumors is exclusively surgery. Arachnoid cyst, on the other hand, is a benign condition that rarely produces symptoms. Recent advances in magnetic resonance imaging (MRI) have allowed more accurate imaging diagnosis of epidermoid tumors. This article reviews the recent advances in MRI using conventional T1W, post-contrast T1W, T2W, steady-state free precession imaging, fluid-attenuated inversion recovery (FLAIR), diffusion-weighted imaging (DWI), and proton magnetic resonance spectroscopy (MRS) in the imaging diagnosis of epidermoid tumors.     

神经内镜下显微外科治疗颅内病变

目的：探讨神经内镜在显微外科治疗颅内病变中的作用。方法：应用神经内镜结合CRW立体定向仪在MRI或CT导向下进行颅内肿瘤活检和囊肿开窗疏通术，或在神经内镜辅助下行小切口开颅手术切除颅内肿瘤和行三又神经根减压术。结果：30例病人，包括4例颅内肿瘤，4例透明隔囊肿，7例蛛网膜囊肿，2例鞍区胆质瘤，5例三又神经痛，8例桥小脑角肿瘤，术后所有病人均恢复良好，无严重并发症出现。结论：神经内镜有助于颅内病变的诊断和治疗，尤其是与立体定向术结合具有微创、准确、简便、并发症少、恢复快等优点，是微侵袭神经外科最重要的治疗手段之一。     

Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) secondary to epidermoid cyst in the right cerebellopontine angle successfully treated with surgery

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome is a rare headache syndrome classified among the trigeminal autonomic cephalalgias. It is usually idiopathic, although infrequent secondary forms have been described. Recently, the term short-lasting unilateral headache with cranial autonomic symptoms (SUNA) has been defined by the International Headache Society (ICHD-2) as similar to SUNCT with less prominent absent conjunctival injection and lacrimation. We report a patient with paroxysmal orbito-temporal pains, phenotypically suggesting SUNA, secondary to epidermoid cyst in the cerebellopontine angle which disappeared after tumor resection. Neuroimaging should be considered in all patients with SUNA, notably in those with atypical presentation as our patient who presented on examination trigeminal hypoesthesia and tinnitus. Realization of a brain MRI would rule out injuries that causes this type of syndrome.     

Cooperative neuro-otologic management of acoustic neuromas and other cerebellopontine angle tumors

Over a recent 16-month period, 35 cerebellopontine angle tumors were removed at our institution by a surgical team consisting of one neurosurgeon and one otologist. Nineteen tumors were less than 2 cm in diameter and six were greater than 4 cm. There were 26 acoustic neuromas, six meningiomas, two epidermoid tumors, and a glossopharyngeal schwannoma. A suboccipital transmeatal approach was used in the majority of patients. There were no deaths. Thirty-two patients had an excellent outcome. Twenty-four patients had complete tumor removal (92% of the acoustic neuromas). The facial nerve was preserved anatomically in all but one patient, who had nerve grafting intraoperatively and has partial recovery of function. Thirteen of the 24 patients who had auditory function retained some of it postoperatively. With current diagnostic techniques, combined with the neurosurgical and otologic team approach, the majority of patients with acoustic tumors of all sizes may expect a complete resection of the tumor with a good outcome. Certainly, early diagnosis and resection of smaller tumors will increase the likelihood that hearing will be preserved, thus providing impetus for aggressive diagnostic and surgical treatment of patients with these lesions.