Zhongguo cuzhong zazhi (Dec 2018)

黏液瘤性颅内多发动脉瘤的发病率分析 Prevalence of Myxomatous Cerebral Aneurysms in Patients with Left Atrial Myxoma

  • 刘龙奇，赵元立，苏亦兵，王昊，叶迅，陈晓霖，马力，王科大

DOI
https://doi.org/10.3969/j.issn.1673-5765.2018.12.005
Journal volume & issue
Vol. 13, no. 12
pp. 1256 – 1261

Abstract

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目的 探讨黏液瘤性颅内多发动脉瘤在具有明确左心房黏液瘤病史人群中的发病情况。 方法 本文以2002年1月-2009年12月北京安贞医院因左心房黏液瘤行手术切除肿瘤，并经术后病理 证实诊断的83例患者为研究对象，患者行全脑数字减影血管造影（digital subtraction angiography，DSA）、 计算机断层扫描血管成像（computed tomography angiography，CTA）或磁共振血管造影（magnetic resonance angiography，MRA）检查，筛查患者中黏液瘤性颅内动脉瘤的发病情况。 结果 83例患者中，48例（58%）经电话随访获取其术后病历资料。48例患者中有3例（6%）去世，其 中1例因术后3年颅内动脉瘤破裂导致脑出血而死亡。32例患者拒绝接受影像学检查，另外13例患者 分别接受DSA、CTA或MRA检查，其中10例为女性，平均年龄42岁，2例诊断为黏液瘤性颅内动脉瘤，一 例为16岁女性，患者颅内动脉瘤多达10个以上，直径2～4 mm，主要累及前循环，另一例为45岁女性， 患者有5个颅内动脉瘤，直径4～12 mm，主要累及基底动脉及右侧大脑中动脉。在本研究中，加上1例 因术后3年颅内动脉瘤破裂导致脑出血死亡患者，黏液瘤性颅内多发动脉瘤发病率为21%（3/14）。 结论 21%的左心房黏液瘤患者继发了颅内多发动脉瘤，但仍需进一步大规模回顾性研究进行验证。 Abstract: Objective To investigate the prevalence of multiple myxomatous intracranial aneurysms in patients with a history of left atrial myxoma (LAM). Methods Patients who had undergone surgery for LAM in Beijing Anzhen hospital from January 2001 to December 2009 were enrolled in this study, who met the inclusion criteria included: the diagnosis of LAM was proved by pathology after operation of LAM; and patients had undergone the whole cerebral digital subtraction angiography (DSA), or computed tomography angiography (CTA), or magnetic resonance angiography (MRA). Results A total of 83 patients were identified, and medical data after surgery were obtained by telephone in 48 (58%) patients. Of the 48 patients, 3 (6%) patients had died and one of them died from cerebral hemorrhage due to ruptured myxomatous cerebral aneurysm at 3 years after surgery. Of the rest (n =45), 32 patients refused the imaging examination and 13 ones (10 females; mean age 42 years old) underwent DSA, CTA or MRA. 2 of the 13 cases were diagnosed with myxomatous intracranial aneurysm. The two patients plus that one died from myxomatous intracranial aneurysm rupture, the prevalence of myxomatous intracranial aneurysm in LAM patients was 21% (3/14). Conclusions LAM patients have a high risk of occurring myxomatous intracranial aneurysm, however further research is needed.

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