NATURAL-HISTORY OF THE CAVERNOUS ANGIOMA
NATURAL-HISTORY OF THE CAVERNOUS ANGIOMA
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DOI：
10.3171/jns.1991.75.5.0709
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发表时间：
1991-11-01
影响因子：
4.1
通讯作者：
LITTLE, JR
中科院分区：
文献类型：
--
作者：
ROBINSON, JR;AWAD, IA;LITTLE, JR
海绵状血管瘤的发病率和自然病程仍不清楚，部分原因是在手术切除前难以诊断和随访。磁共振（MR）成像的引入提高了诊断和随访这种血管畸形的敏感性和特异性。在1984年至1989年期间在克利夫兰诊所进行的14，035次连续MR图像中，在66名患者中发现了76个具有典型的假定海绵状血管瘤MR表现的病变。在平均26个月的随访研究中，86%的病例提供了143个病变年的临床调查。最常见的临床表现为癫痫发作、局灶性神经功能缺损和头痛。虽然大多数病变在MR成像上显示出隐匿性出血的证据，但在57例有症状的患者中有7例明显出血，在随访期间仅发生1例明显出血。年出血率为0.7%。对出血组的分析显示，女性明显出血的风险显著更高。14例手术病例均经病理证实为海绵状血管瘤。这一信息有助于合理的治疗计划和预后的患者磁共振图像显示病变提示海绵状血管瘤。
The incidence and natural history of the cavernous angioma have remained unclear in part because of the difficulty of diagnosing and following this lesion prior to surgical excision. The introduction of magnetic resonance (MR) imaging has improved the sensitivity and specificity of diagnosing and following this vascular malformation. Seventy-six lesions with an MR appearance typical of a presumed cavernous angioma were discovered in 66 patients among 14,035 consecutive MR images performed at the Cleveland Clinic between 1984 and 1989. Follow-up studies in 86% of the cases over a mean period of 26 months provided 143 lesion-years of clinical survey of this condition. The most frequent presenting features were seizure, focal neurological deficit, and headache. While most lesions exhibited evidence of occult bleeding on MR imaging, there was overt hemorrhage in seven of the 57 symptomatic patients and only one overt hemorrhage occurred during the follow-up interval. The annualized bleeding rate was 0.7%. Analysis of the hemorrhage group revealed a significantly greater risk of overt hemorrhage in females. Pathological confirmation of cavernous angioma was obtained in all 14 surgical cases. This information assists in rational therapeutic planning and prognosis in patients with MR images showing lesions suggestive of cavernous angioma.