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U máng mạch trên không: sự tương quan giữa kiểu hình, giới tính và lãnh thổ mạch máu bị ảnh hưởng
Tóm tắt
U máng mạch trên là những tổn thương mạch máu hiếm gặp. Sự hiện diện của các u nang quanh khối u và phù nề có ý nghĩa lâm sàng, chẩn đoán và điều trị. Tuy nhiên, cơ chế hình thành cả u nang và phù nề vẫn chưa được hiểu rõ. Nghiên cứu này nhằm xác định liệu kiểu hình hình ảnh của u máng mạch trên có bị ảnh hưởng bởi các lưu thông động mạch não khác nhau hay không. Việc xem xét tài liệu tiếng Anh từ 1973 đến 2023 đã thu được 53 trường hợp u máng mạch nhu mô trên đủ điều kiện phân tích. Bệnh nhân được chia theo sự phân bố lãnh thổ mạch máu của tổn thương: lưu thông trước (n = 36) hoặc lưu thông sau (n = 17), và các nhóm được so sánh về các biến số nhân khẩu học, lâm sàng, hình ảnh và phân tử. Phân tích đơn biến cho thấy sự khác biệt có ý nghĩa giữa các nhóm ở năm biến số. Các thay đổi dạng u nang và kiểu hình hình ảnh “cổ điển” liên quan đến u máng mạch thuộc lưu thông sau (OR = 0.19, p = 0.045 và OR = 0.287, p = 0.048), trong khi giới tính nữ, phù nề quanh u đáng kể và kiểu hình thuần đặc liên quan đến u máng mạch thuộc lưu thông trước (OR = 3.384, p = 0.045 và OR = 5.25, p = 0.05 và OR = 14.0, p = 0.015; tương ứng). Trong phân tích đa biến, kiểu hình đặc và giới tính nữ vẫn có sự liên quan đáng kể với lưu thông trước (OR = 36.04, p = 0.014 và OR = 4.45, p = 0.045). Tỷ lệ bệnh von-Hippel Lindau cao hơn ở nhóm lưu thông trước. Các khối u dạng u nang có mặt ở tất cả các nữ giới trong nhóm lưu thông sau so với 43.4% ở nhóm lưu thông trước (OR = 20.714, 95% CI 1.061 đến 404.122; p = 0.045). Dựa trên các trường hợp lịch sử của u máng mạch trên, nghiên cứu này cho thấy rằng các kiểu hình khối u khác nhau có liên quan đến các lưu thông não khác nhau. Giới tính cũng được liên kết với sự khác biệt trong phân bố khối u và kiểu hình hình ảnh. Những dữ liệu mới này có thể cải thiện sự hiểu biết của chúng ta về các bệnh mạch máu độc đáo của hệ thần kinh trung ương.
Từ khóa
#u máng mạch #u nang #phù nề #lưu thông động mạch não #giới tính #kiểu hình #Tài liệu tham khảo
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