Clinical Diagnosis And Treatment Of Cavernous Sinus Hemangiomas:Report Of 19 Cases

The incidence of cavernous sinus hemangiomas(CSHs)is low.And this disease is a benign tumor that accounts for about 2% of all tumors in the cavernous sinus region.The disease is easily misdiagnosed with other common tumors in the cavernous sinus region.Magnetic resonance imaging(MRI)has a high value in the diagnosis of CSHs.The clinical manifestations of CSHs are more common with headache and cranial nerve palsy.The tumor is close to internal carotid artery,cranial nerves or other important structures in this region,high risk of bleeding during operation make the CSHs microsurgery difficult.Postoperative complications are common to see,and the total removal of tumor is not easy.This study collected MRI imaging data and clinical data of 19 cases CSHs patients that received surgical treatment,as well as MRI imaging data of 53 cases cavernous sinuses other tumor patients from the First Affiliated Hospital of Zhengzhou University in the period of January 2014 to January 2017.Through statistical analysis,and combined with literature reports of domestic and foreign,discussed the MRI features and therapeutic effects of the disease.ObjectiveThe purpose of this study is to improve the MRI diagnosis and microsurgical treatment of CSHs.To investigate the precautions of microsurgery in the treatment ofCSHs,and analyze the therapeutic effects and complications of microsurgery on CSHs patients.So as to promote the diagnosis and treatment of CSHs.MethodsMRI imaging data and clinical data of 19 patients with CSHs who had received surgery in the First Affiliated Hospital of Zhengzhou University from January 2014 to January 2017 were collected,as well as MRI imaging data of 53 patients with cavernous sinuses other tumor were compared.Combined with literature reports of domestic and foreign to analyses the collected data.Results1.Through the univariate and multivariate analysis of the four MRI imaging features between the CSHs group and other tumors of cavernous sinus,T2 WI homogeneous signal and T2 WI high signal similar to cerebrospinal fluid are significant in distinguishing CSHs and other cavernous sinus tumors.Combine them as a diagnostic indicator of CSHs,the sensitivity was 85.9%,specificity was 92.8%,and accuracy was 91.6%.2.All the CSHs patients received microsurgical treatment.There were no death.The number of total removal is 10(52.63%),subtotal removal is7(36.84%),and partial removal is 2(10.52%).The symptoms of headaches were improved after surgery,as well as some cranial nerve palsy symptoms.After surgery,the number of oculomotor nerve palsy is 10(52.63%),abducens nerve palsy is 6(31.57%),trigeminal nerve palsy is 3(15.78%),vision loss is 2(10.52%),and 5 cases of two or more cranial nerves injury.ConclusionHomogeneous and high signal that is similar to cerebrospinal fluid in the T2 WI imaging has a very high value in diagnosis of CSHs;Microsurgical treatment in CSHs patients is an effective method.Due to the complexity of the anatomy structure in this region,the total removal rate of the CSHs and the incidence of cranial nerveinjury caused by surgery is not optimistic.Radiosurgery treatments can be used as one of the choice in patients with CSHs.