[1]黎开谷,梁平,李映良,等.儿童颅骨骨膜窦12例临床分析[J].第三军医大学学报,2011,33(15):1629-1632.
 Li Kaigu,Liang Ping,Li Yingliang,et al.Sinus pericranii in children: clinical features and therapeutic management[J].J Third Mil Med Univ,2011,33(15):1629-1632.
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儿童颅骨骨膜窦12例临床分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
33卷
期数:
2011年第15期
页码:
1629-1632
栏目:
论著
出版日期:
2011-08-15

文章信息/Info

Title:
Sinus pericranii in children: clinical features and therapeutic management
作者:
黎开谷梁平李映良翟瑄周渝冬李禄生夏佐中
重庆医科大学附属儿童医院神经外科
Author(s):
Li Kaigu Liang Ping Li Yingliang Zhai Xuan Zhou Yudong Li Lusheng Xia Zuozhong
Department of Neurosurgery, Children’s Hospital, Chongqing Medical University, Chongqing, 400014, China
关键词:
颅骨骨膜窦诊断手术治疗儿童
Keywords:
sinus pericranii diagnosis surgery therapy children
分类号:
R726.51; R743.4
文献标志码:
A
摘要:
目的     探讨儿童颅骨骨膜窦的临床特点及治疗。     方法      回顾性分析并总结我科2000年1月至2010年12月收治的12例颅骨骨膜窦患儿的临床资料,无症状、可复性、中线附近的头皮下肿块为其典型临床表现,其中位于顶部4例,额部3例,枕部3例,颞部2例。所有患儿均行CT、颅骨三维重建、MRI、CTA或MRV检查。手术切除颅骨外血窦,封堵沟通静脉孔或修补颅骨缺损。     结果      头颅CT显示颅骨外软组织肿块影,增强后可见点片状强化,肿块下方颅骨变薄或缺损。三维重建显示局部颅骨变薄,虫蚀样改变。CTA显示局部异常血管团通过板障静脉/导静脉与硬脑膜静脉窦相通,其血供来源于硬脑膜静脉窦,且最终回流至硬脑膜静脉窦。MRI显示T1加权像呈蜂窝状等信号或低信号改变,T2加权像可见等信号或高信号改变,3例显示病灶穿透颅骨内板与颅内相交通。MRV显示颅外肿块与静脉窦沟通,并有局部硬脑膜静脉窦明显增粗。病理检查结果显示,大量扩张的无肌层血管组成的囊腔,腔壁内衬单层扁平内皮细胞或结缔组织。12例术后肿块消失,头颅外形满意,无颅高压症状,复查CT颅内无血肿形成,随访6个月至5年,均无复发。     结论       结合大小随颅内压改变的可复性头皮下包块的临床表现和CT、MRI、CTA或MRV等影像学检查,易于诊断儿童颅骨骨膜窦,该病通过手术切除治疗可获得良好效果。
Abstract:
Objective      To investigate the clinical features and therapeutic management for sinus pericranii in children.      Methods      A retrospective review of 12 children with sinus pericranii pathologically confirmed by surgical resection was performed. They were 9 males and 3 females, with an age ranging from 3 month to 9 years and 7 months (mean 2 years and 9 months). The lesion was located in the midline in 10 of 12 patients, including 4 in the parietal, 3 in the occipital, and 3 in the frontal. The lesion of 2 patients was in a temporal off-midline. The characteristic feature of this abnormality was that its size depended on intracranial pressure and central venous pressure. All cases of sinus pericranii were of progressively enlarging tumors. Minimally invasive procedures were performed, such as tumor excision, resection of the communication site by electrocoagulation, and bone wax and fibrin sealant filling of the same site.      Results      CT scan showed a prominent soft tissue mass superficial to the thinning skull. Three-dimensional volume-rendered CT reconstruction (3D-CT) demonstrated multiple small diploic holes and erosion of the skull bone. The transcranial connection was visualized using CT angiography (CTA) or MR venography (MRV). The postoperative course was uneventful. The pathological examination showed the mass was of a thin-walled cystic lesion. Microscopic examination of the cystic mass revealed that the cystic mass was lined by a single layer of flattened endothelial cells or a connective tissue. All 12 patients were followed up for 6 months to 5 years, and the results showed no relapse or any complication.      Conclusion      Sinus pericranii in children has typical clinical manifestations and imaging features. Surgical resection obtains excellent or good outcome.

参考文献/References:

黎开谷, 梁平, 李映良, 等. 儿童颅骨骨膜窦12例临床分析[J].第三军医大学学报,2011,33(15):1629-1632.

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更新日期/Last Update: 2011-07-21