术中高场强MRI辅助显微外科手术治疗颞叶癫痫  

Intraoperative magnetic resonance imaging-assisted microsurgery for temporal lobe epilepsy (report of 18 cases)

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

机构地区：[1]南京军区南京总医院神经外科,南京210002

出　　处：《中国临床神经外科杂志》2012年第10期598-600,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨应用术中高场强MRI辅助显微外科手术治疗颞叶癫痫的效果。方法 2011年6月至2012年4月,对结构性异常的颞叶癫痫患者18例,利用1.5T高场强MRI实时辅助,术前术中常规行T1、T2及T1加权、弥散张量成像检查,以确定显微手术切除范围及功能区。结果术后病检结果示右侧颞叶海绵状血管瘤2例,左侧颞叶海绵状血管瘤3例,右侧颞叶弥漫性少枝星形细胞瘤2例,左侧海马硬化4例,右侧海马硬化6例,左侧颞叶胚胎发育不良性神经上皮肿瘤1例。术后复查MRI手术切除满意,无手术并发症。术后随访2个月～1年,EngelⅠ级14例,Ⅱ级4例。结论术中1.5T高场强MRI辅助显微外科手术治疗结构性异常的颞叶癫痫,可以较完全切除致痫灶,并保护神经功能,手术安全和效果好。Objective To evaluate the curative effect of the intraoperative magnetic resonance imaging （MRI）-assisted microsurgery on the temporal lobe epilepsy （TLE）. Methods The intraoperative 1.5T MRI-assisted microsurgery was performed from June, 2011 to April, 2012 in 18 patients with TLE in whom brains had organic lesions. T1, T2, weighed T1 and diffusion tensor imaging before and during operation were applied to the identification of the functional cerebral region and lesions to be resected. Results Of 18 patients with TLE, 2 had right temporal lobe angiocavernomas, 3 left temporal lobe angiocavernomas, 2 right temporal lobe diffuse astrocytomas, 4 left hippocampi sclerosis, 6 right hippocampi sclerosis and l left temporal lobe dysembryoplastic neuroepithelial tumor. The postoperative MRI showed that the intracranial lesions were totally removed in all the patients. All the patients were followed up from 2 to 12 months. The outcomes were Engel grade Ⅰ in 14 patients and grade Ⅱ in 4. No complication was observed during the follow-up. Conclusions The epileptogenic loci may be totally removed by intraoperative 1.5T MRI-assisted mierosurgery which is safe and has good effect on TLE in the patients with intracerebral organic lesions.

关 键 词：术中MRI 颞叶 癫痫 颅内病变 显微外科 

分 类 号：R742[医药卫生—神经病学与精神病学] R651[医药卫生—临床医学]