上矢状窦旁脑膜瘤致上矢状窦阻塞时侧支静脉通路的意义

目的 分析上矢状窦旁脑膜瘤致上矢状窦(SSS)阻塞时其侧支静脉通路的建立情况，确定其在肿瘤切除术中的意义。方法 总结归纳86例上矢状窦旁脑膜瘤行MRA及DSA检查时的静脉系表现。结果 27例发生SSS完全阻塞，59例部分阻塞。18例在阻塞的SSS周围出现了由表浅皮层静脉所形成的侧支静脉环；通过表浅皮层静脉与蝶顶窦及小脑幕静脉系建立端—端吻合的16例；通过与Troland或Labbe静脉建立吻合的14例；通过大脑镰与下矢状窦吻合的9例；通过脑膜静脉并经板障静脉引流到颈外静脉系的17例；混合型12例。结论 上矢状窦旁脑膜瘤致SSS阻塞时，肿瘤周围存在广泛侧支静脉通路，术中应注意保护。脑DSA及MRA检查对术前了解SSS通畅性及侧支静脉通路建立有帮助。

Significance of Establishing Collateral Venous Pathway on Occlusion of Surperior Sagittal Sinus caused by Meningioma

Objective To analyses the establishment of the collateral venous pathway shown by MRA and DSA on the occlusion of the superior sagittal sinus (SSS) caused by the meningioma and to explore the method to deal with it during removing the tumor involving the SSS. Methods The imaging (MRA and/or DSA) data of 86 cases with parasagittal meningiomas were analyzed retrospectively. Results Of 86 patients with parasagittal meningiomas, 27 suffered from total occlusion of the SSS and 59 part. The collateral venous circulatiom was formed by the superficial cortical vein around the tumors in 18 cases. The anastomosis among the cortical bridge vein, tentorium venous sinus and other basal venous sinus were found in 16 cases, between the SSS and troland or Labbe vein in 14 and between the cerebral falx and inferior sugittal sinus in 9. The collateral pathways between the SSS and external jugular vein through the veins of dure matter and diploe were established in 17. The multiple pathways were established in 12. Conclusion There are important collateral venous pathways around the parasagital meningioma which produces occlusion of the SSS. The collateral venous pathways, which can be diagnosed by MRA and DSA, should be defended from injury during the operation.