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目的 讨论颅内原发性黑色素瘤的临床表现、影像学特征及治疗方法。方法 对本科近 15年来手术治疗的 5例颅内原发性黑色素瘤进行回顾性分析。结果 颅内原发性黑色素瘤的临床表现不具有特征性 ,影像学上CT表现为高密度或混杂密度 ,增强扫描呈均一或不同程度强化 ,核磁共振检查 (MRI)表现为短T1短T2 信号 ,也可以因顺磁性黑色素含量的不同而表现为高、低或混杂信号 ,注射二乙胺五乙酸钆 (GD -DTPA)后则出现程度不等的强化。 5例患者中 3例手术全切 ,2例大部分切除。结论 颅内黑色素瘤的预后差 ,对于颅内黑色素瘤主张在手术的基础上进行包括放疗及化疗的综合治疗 ,手术时在不影响功能的前提下争取全切肿瘤。
Objective To discuss the clinical manifestations, imaging features and treatment of intracranial primary melanoma. Methods A retrospective analysis of 5 cases of intracranial primary melanoma undergoing surgical treatment in recent 15 years was conducted. Results The clinical manifestations of intracranial primary melanoma did not have characteristic features. CT showed high density or mixed density on imaging. The contrast enhancement scan showed uniform or different enhancement. MRI showed short T1 short T2 signal , But also due to paramagnetic melanin content showed different high and low or mixed signals, after injection of gadolinium diethylenetriaminepentaacetic acid (GD-DTPA), there are varying degrees of enhancement. Three of the five patients underwent total surgical resection and two were mostly resected. Conclusion The prognosis of intracranial melanoma is poor. For intracranial melanoma, it is advocated that comprehensive treatment including radiotherapy and chemotherapy should be taken on the basis of surgery. The operation should aim to achieve complete tumor removal without affecting the function.