术中高场强磁共振联合锥体束导航在丘脑胶质瘤切除手术中的应用  

Intraoperative high field magnetic resonance imaging combined with pyramidal tract navigation for resection of thalamic gliomas

作　　者：吴东东[1] 陈晓雷[1] 耿杰峰[1] 张猛[1] 白少聪 王群[1] 马晓东[1] 许百男[1] 

机构地区：[1]解放军总医院神经外科,北京100853

出　　处：《解放军医学院学报》2015年第7期694-698,共5页Academic Journal of Chinese PLA Medical School

基　　金：国家自然科学基金项目(3080049)~~

摘　　要：目的探讨术中高场强磁共振联合锥体束导航在丘脑胶质瘤切除手术中的应用价值。方法回顾性研究2009年3月-2014年4月本院神经外科收治的28例接受1.5 T高场强术中磁共振联合锥体束导航辅助显微切除手术的丘脑胶质瘤患者临床资料,分析评估了所有患者的肿瘤切除程度、术前术后行为状态评分(Karnofsky performance scale,KPS)和肌力。结果 28例患者中有22例术中扫描后发现肿瘤残留,其中15例患者的残留肿瘤得以进一步切除,提高了肿瘤切除程度。术后3周,22例神经功能改善或同术前,6例神经功能下降,但是功能下降者KPS均>60,即生活均可自理。结论术中高场强磁共振联合锥体束导航有助于提高丘脑胶质瘤切除程度,减少术后运动功能障碍的发生率。Objective To explore the clinical value of high field iMRI combined with pyramidal tract navigation on the resection of thalamic gliomas. Methods Clinical data about 28 patients with thalamic gliomas admitted to our hospital from March 2009 to April 2014 were retrospectively analyzed. All patients underwent mierosurgery aided by iMRI combined pyramidal tract navigation. The extent of resection （EOR） of tumors, pre- and post-operative Karnofsky performance scale （KPS） and myodynamia were evaluated. Results iMRI scanning revealed residual tumors in 22 of 28 patients, and 15 patients received further resection which increased EOR. Three weeks after surgery, neurological functions improved or kept no change in 22 cases, and 6 cases experienced neurological function decline, however, the KPS score of these 6 patients were higher than 60, which suggested that the patients could take care of themselves. Conclusion iMRI combined with pyramidal tract navigation is helpful to maximize the resection of thalamic gliomas and decrease incidence of the neurologic deficits.

关 键 词：术中磁共振 锥体束导航 丘脑胶质瘤 

分 类 号：R651.1[医药卫生—外科学]