电生理监测及光学成像定位显微手术切除中央沟区脑胶质瘤  

Optical intrinsic signal imaging and neuromonitoring mapping for surgery of glioma near the central sulcus

作　　者：蒋宇钢[1] 周倩[1] 张明铭[1] 

机构地区：[1]中南大学湘雅二医院神经外科,长沙410011

出　　处：《中华显微外科杂志》2011年第3期198-200,269,共4页Chinese Journal of Microsurgery

摘　　要：目的探讨中央沟区手术中应用电生理监测及光学成像技术定位脑运动及感觉功能区的方法及意义。方法5例中央沟区脑胶质瘤患者术中首先利用电生理监测技术定位中央沟及中央前回运动功能区，然后通过光学成像定位中央后回感觉功能区。根据术中的定位，选择显微手术对肿瘤切除，最后进行功能情况评估。结果临床应用5例，均成功定位中央沟及相应的感觉、运动功能区。术后24h内复查MRI显示均达到肿瘤全切除。术后随访3～12个月，5例患者的感觉、运动功能基本恢复正常。结论联合使用术中电生理监测技术及光学成像技术定位患者的躯体运动和感觉功能区是显微手术切除中央沟区脑胶质瘤的一种安全与有效的方法。Objective To study the methods and significance of motor and sensory areas mapping by optical intrinsic signal imaging （IOSI） and neuromonitoring （IOM） during the operation on the lesions near the central sulcus. Methods Intraoperative neuromonitoring were firstly used to map the central sulcus and motor cortex in 5 patients with glioma undergoing surgery. Then, intrinsic optical signals imaging were used to locate the postcentral gyrus. According to the results of mapping, microsurgical operation was chosen for the resection of glioma and postoperative functional results were evaluated. Results All the patients acquired accurate location of central sulcus, motor cortex and somatosensory cortex. The enhanced MRI performed within 24 hours postsurgery showed total resection in 5 cases. The motor and somatosensory function of 5 patients returned to normal after 3-12 months. Conclusion Intraoperati^e location of the somatosensory area and motor area by optical intrinsic signal imaging and neuromonitoring is a reliable and safe method.

关 键 词：脑 胶质瘤 电生理监测 光学成像 显微手术 

分 类 号：R739.4[医药卫生—肿瘤]