岛叶胶质瘤的手术治疗经验  

The experience from surgical management of insular lobe gliomas

作　　者：王睿智[1] 闫前锦 高李贵[1] 师蔚[1] 吕健[1] 屈建强[1] 巩守平[1] 

机构地区：[1]西安交通大学第二附属医院神经外科,陕西西安710004 [2]陕西省武功县人民医院神经外科,陕西武功712200

出　　处：《现代肿瘤医学》2015年第17期2417-2420,共4页Journal of Modern Oncology

基　　金：西安交通大学医学院第二附属医院新技术新疗法项目(编号:3030530-2029)

摘　　要：目的:总结岛叶胶质瘤的治疗经验,并探讨3.0T磁共振(magnetic resonance imaging,MRI)及术中B超技术在岛叶胶质瘤手术治疗中的应用。方法:回顾性分析18例岛叶胶质瘤患者,总结术前3.0T-MRI检查对手术参考价值并分析术中B超技术辅助肿瘤切除的意义。结果:6例(33%)患者术前因癫痫大发作和颅内压增高导致病情迅速恶化,采取急诊手术治疗,余12例患者行择期手术。术前3.0T-MRI对肿瘤边界及外侧豆纹动脉提供详细信息,术中B超可对肿瘤进行定位,并能够实时观察肿瘤切除程度,有利于最大程度切除肿瘤,但对于低级别胶质瘤,超声造影效果受限。结论:颅内压增高合并癫痫发作的岛叶胶质瘤需尽早手术。术前3.0T-MRI检查及术中B超技术有利于保护外侧豆纹动脉,并有助于最大程度切除肿瘤。Objective：To summarize the experience of the treatment of insular lobe glioma and investigate the ap-plication of preoperative 3. 0T-MRI and intraoperative B ultrasound in the operation. Methods：A total number of 18 cases were reviewed retrospectively. The treatment processes were analyzed and the experience and lessons were pres-ented. The preoperative 3. 0T-MRI and intraoperative B ultrasound advantages and disadvantages of the two tech-niques were summarized. Results：Six cases（33%）had emergent operation due to deteriorated condition caused by increased intracranial pressure and seizure. Twelve cases had selective surgery. 3. 0T -MRI clearly visualized the LSAs and the tumor margins. B ultrasound serves as a real-time monitor and helps to remove the tumor to the grea-test degree. However,the effect of contrast-enhanced ultrasonography is limited with low grade insular glioma. Con-clusion：An early operation was necessary for the cases manifested with increased intracranial pressure and seizure. Preoperative 3. 0T-MRI and B ultrasound can help to protect the LSAs and assist the resection of insular glioma.

关 键 词：岛叶胶质瘤 3. 0T磁共振 术中B超 

分 类 号：R730.264[医药卫生—肿瘤] R730.56[医药卫生—临床医学]