术中磁共振及神经导航在脑深部微小病变手术中的应用  

Microsurgery assisted by intraoperative magnetic resonance imaging and neuronavigation for small lesions in deep brain

作　　者：宋志军[1] 陈晓雷[1] 许百男[1] 孙正辉[1] 孙国臣[1] 赵岩[1] 王飞[1] 王宇博[1] 周定标[1] 

机构地区：[1]解放军总医院神经外科,北京100853

出　　处：《中华医学杂志》2012年第1期25-27,共3页National Medical Journal of China

基　　金：基金项目：国家自然科学基金（30800349）;北京市自然科学基金（7102145）

摘　　要：目的 评价术中磁共振（iMRI）及神经导航辅助切除脑深部微小病变的效果.方法 解放军总医院从2009年2月至2011年1月应用（iMRI）及神经导航系统切除脑深部微小病变（病灶与皮层距离≥2 cm,病灶最大直径≤30 mm）切除术42例,当术中难以找到病变时中止手术,放置骨蜡进行参照,进行（iMRI）,采用更新的术中影像进行导航,指导手术进一步切除病变.结果 42例病变均成功找到病灶,40例进行影像学意义上的全切,2例因病变过于靠近重要功能区行次全切,无死亡病例,术后早期3例患者出现低于术前的功能障碍,随访3个月,2例恢复至等于或高于术前水平.结论 （ iMRl）能及时采用最新的影像发现残余病灶和纠正脑移位,神经导航定位精确度高,二者结合切除颅内深部微小病变效果佳.Objective To explore the practicability of resecting small lesions in deep brain by intraoperative magnetic resonance imaging （iMRI） and neuronavigator-assisted microsurgery and its clinical efficacies.Methods A total of 42 cases with small lesions in deep brain underwent intraoperative MRI and neuronavigator-assisted microsurgery.The drifting of neuronavigation was corrected by images acquired from intraoperative MR rescanning.Results All lesions were successfully identified and 40 cases totally removed without mortality.Only 3 cases developed new neurological deficits post-operatively while 2 of them returned to normal neurological functions after a follow-up duration of 3 months to 2 years.Conclusion The application of intraoperative MRI can effectively correct the drifting of neuronavigation and enhance the accuracy of microsurgical neuronavigation for small lesions in deep brain.

关 键 词：磁共振成像 神经导航 神经外科 脑 

分 类 号：R651.1[医药卫生—外科学]