Objective To evaluate the application value of head CT angiography for preoperative evaluation of patients with skull base meningioma. Methods The clinical data of 28 patients with skull base meningioma were analyzed retrospectively. To learn the relationship between tumor and blood vessels, preoperative head CTA examination was taken. The appropriate surgical resection was taken to protect the blood vessels. Results Preoperative head CTA showed the size of the tumor, the base, and the source of blood supply. It showed the third-level structure of the intracranial artery. It clearly showed the three-dimensional image relationship of tumors, blood vessels, and skulls, and can distinguish between tumors and nearby blood vessels. The results of the operation showed that 8 cases of Simon Ⅱ stage resection, 16 of Ⅲ stage resection, and 4 of Ⅳstage resection. No cerebral infarction, no vascular damage after operation. Karnofsky scored 17. 5 points higher than the preoperative average, followed up 6 to 36 months. 25 patients had no recurrence, and 3 had residual tumor growth recurrence. Conclusion The preoperative CTA can distinguish the relationship between the skull base tumor and the adjacent blood vessel, which is beneficial to the protection of blood vessels, and provides intuitive information for the operation of skull base meningioma.%目的 探讨头部CT三维血管成像检查对颅底脑膜瘤术前评估的应用价值.方法 回顾性分析玉林市第一人民医院神经外科手术治疗的28例颅底脑膜瘤患者的资料.患者术前均进行头部CT三维血管成像检查, 了解肿瘤与血管的关系;术中采取适当的手术策略切除肿瘤, 同时保护血管.结果 术前头部CT三维血管成像检查能显示肿瘤的大小、基底、供血来源, 以及颅内动脉3级结构;并能清楚地显示肿瘤、血管、颅骨的三维影像关系, 能分辨肿瘤与附近血管的直接关系.手术结果:SimponⅡ级切除者8例, Ⅲ级切除者16例, Ⅳ级切除者4例;术后无发生脑梗死和血管损伤的患者.术后, Karnofsky评分较术前平均提高17. 5分;随访6～36个月, 25例患者无复发, 3例患者残留肿瘤复发, 再次手术.结论 术前CT三维血管成像能分辨颅底肿瘤与附近血管的关系, 利于血管保护;为颅底脑膜瘤手术提供直观的信息.
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