立体定向活检诊断大脑胶质瘤病(附17例临床分析)  

Application of stereotactic biopsy for diagnosis of gliomatosis cerebri

作　　者：李朝晖[1] 赵兴利[1] 杨华[2] 王连友[2] 田增民[3] 田宇[1] 李旭[4] 于新[3] 

机构地区：[1]吉林大学中日联谊医院神经外科二病区,长春130031 [2]吉林大学中日联谊医院病理科,长春130031 [3]中国人民解放军海军总医院全军神经外科中心 [4]辽源市中心医院神经外科

出　　处：《立体定向和功能性神经外科杂志》2008年第6期336-340,共5页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：国家自然科学基金项目(编号:30672159);教育部新世纪优秀人才支持计划(编号:NCET-06-0306)

摘　　要：目的探讨立体定向活检手术在大脑胶质瘤病诊断中的应用价值,提高大脑胶质瘤病的诊断水平。方法对影像学显示颅内病灶侵犯2个以上脑叶的患者行立体定向活检术。安装日本驹井式或Leksell立体定向头架,行CT或MRI增强扫描,利用"四点一线手算法"确定包含入颅点、靶点及靶点前后各10mm点共四个点的三维长轴,或采用计算机辅助立体定向手术系统(CAPN)计算靶点坐标及规划活检入颅。所取标本送病理学检查。结果经病理证实,17例诊断为大脑胶质瘤病,其中星形细胞瘤Ⅰ级3例,Ⅱ级8例,Ⅱ～Ⅲ级2例,Ⅲ级4例。未出现因活检手术而造成的出血、偏瘫等严重并发症。17例患者术后均给予相应的治疗。结论立体定向活检术对于明确诊断大脑胶质瘤病,具有重要的应用价值。Objective To investigate the role of stereotactic biopsy for pathological diagnosis of gliomatosis cerebri, meanwhile explore the diagnosis methods of gliomatosis cerebri. Methods Stereotaetic biopsies were performed in patients with intracranial lesions infiltrating more than two lobes. All the procedures were done under local anesthesia with CT or MRI guided stereotactic system. The ＂four point-one line＂ hand count method and Computer-assisted Planning for Neurosurgery （CAPN） were used to determine the coordinate. The specimens obtained from stereotactic biopsy were underwent pathological exam. Results Conclusive histopathological diagnosis was achieved in all cases. 17 cases were diagnosed as gliomatiosis cerebri. All the 17 cases were astrocytomas, the grades were as follow. 3 case of grade Ⅰ , 8 cases of grade Ⅱ , 2 case of grade Ⅱ-Ⅲ, 4 cases of grade Ⅲ. No serious complication （intracranial hematoma, paralysis） caused by brain biopsy occurred in all seventeen patients. Conclusion The result suggests that imaging guided stereotaetic biopsy is a rapid and reliable method for histopathological diagnosis of gliomatosis cerebri.

关 键 词：大脑胶质瘤病 立体定向手术 活体组织检查 免疫组化 诊断 

分 类 号：R739.41[医药卫生—肿瘤]