术中1.5T核磁共振外科治疗难治性癫癎  

Intraoperative 1.5T magnetic resonance imaging for refractory epilepsy

作　　者：孙康健[1] 王汉东[1] 王正阁[1] 杭春华[1] 樊友武[1] 田蕾[1] 黄丹[1] 刘开东[1] 潘灏[1] 

机构地区：[1]南京军区南京总医院神经外科,210002

出　　处：《临床神经外科杂志》2012年第2期91-93,共3页Journal of Clinical Neurosurgery

摘　　要：目的探讨应用术中1.5T核磁共振(MRI)治疗难治性癫癎的手术效果。方法手术治疗难治性癫癎15例,利用术中1.5T核磁共振,术前常规行T1、T2及T1加强,及弥散张量成像,术中切除(切开)后行T1、T2及T1加强及弥散张量成像检查,以确定切除范围及功能区定位,其中5例术中MR检查后扩大切除。结果左侧枕叶局灶性皮质发育异常2例,左侧颞叶海绵状血管瘤4例,左侧颞叶海马硬化1例,右侧额叶胚胎发育不良性神经上皮肿瘤1例,右侧中央前回局灶性皮质发育不良1例,右侧颞叶海马硬化1例,右侧颞叶海绵状血管瘤1例,右侧颞叶胶质瘤1级1例,右侧中央后回海绵状血管瘤1例,胼胝体切开2例,engle分级:Ⅰ级11例,Ⅱ级4例。结论术中1.5T核磁共振对切除(切开)病灶及功能保护有指导意义。Objectives To evaluate the intraoperative 1.5T magnetic resonace imaging （MRI） for refractory epilepsy surgery. Methods A total of 15 patients with refractory epilepsy accepted surgery. T1, T2, weighed Y1 and diffusion tensor imaging before and during operation were applied to identify functional region and lesions to be resected. Extended resection was performed in 5 patients after intraoperation MRI. Results After operation, focal cortical dysplasia （FCD） in left occipital lobe was diagnosed in 2 patients,left temporal lobe angioeavernoma in 4, left temporal lobe hippocampi scleorosis in 1, right frontal lobe dysembryoplastic neuroepithelial turnout in 1, fight anterior central convolution FCD in 1, right temporal lobe hippocampi seleorosis in 1, right temporal lobe angiocavernoma in 1, right temporal lobe Grade I glioma in 1, right posterior central convolution angioeavemoma in 1 and front callosum section in 2. Engle Grade I in II patients and Grade II in 4. Conclusions Intraoperative 1. 5T MRI can guide the localization for epileptic lesion and protection for functional brain region.

关 键 词：术中磁共振成像 癫癎 手术 

分 类 号：R742.1[医药卫生—神经病学与精神病学]