神经导航结合DTI技术在切除大脑功能区肿瘤的应用  

Applications analysis of Neuronavigation combined with DTI technology in resection of brain tumors

作　　者：聂柳[1] 邢孔学 刘兴吉[3] 夏鹰[1] 金虎[1] 陈建强[1] 陈晓东[1] 林佳[1] 

机构地区：[1]海口市人民医院神经外科,海南海口570208 [2]乐东黎族自治县第二人民医院 [3]吉林大学第一医院

出　　处：《中国实验诊断学》2017年第5期802-805,共4页Chinese Journal of Laboratory Diagnosis

基　　金：海口市科技项目(课题编号:2011-SKG-12-124)

摘　　要：目的探讨神经导航结合弥散张量成像(DTI)技术在切除大脑功能区肿瘤中的应用,对降低患者致残率及提高肿瘤全切率的意义。方法选取2012年1月至2014年12月医院收治的36例颅脑功能区肿瘤患者为研究对象,按数字表法随机均分为对照组(18例)和观察组(18例),其中观察组采用神经导航结合DTI技术辅助手术治疗,对照组患者则采用传统手术方式切除肿瘤,比较两组患者肿瘤全切率,采用Karnofsky功能状态评分(KPS评分)评估患者术后机体功能状态。结果对照组患者肿瘤全切除8例(44.44%),观察组患者肿瘤全切除15例(83.33%),两组比较差异具有统计学意义(χ~2=5.8997,P<0.05);对照组患者10例(55.56%)KPS评分≥70分,观察组患者16例(88.89%)KPS评分≥70分,两组比较差异具有统计学意义(χ~2=4.9846,P<0.05),且两组KPS评分得分比较有统计学差异(P<0.05);观察组患者在随访过程中14例无症状生存,2例病情复发,2例伴有癫痫症状;对照组患者9例无症状生存,4例出现病情复发,死亡2例,3例伴有长期不完全性运动功能障碍。结论神经导航结合弥散张量成像技术可明确肿瘤切除范围,有利于提高大脑功能区肿瘤全切率,改善患者术后机体功能状态,保护大脑功能同时最大范围切除肿瘤。Objective This aim is to explore the applications of neuronavigation combine with diffusion tensor imaging（DTI） technology in the removal of tumors in the brain,and the significance in reducing morbidity and increase the rate of total tumor resection. Methods A total of 36 cancer patients with brain functional areas from January 2012 to December 2014 in our hospital were selected. They were randomly divided into control group（18 cases） and observation group（18 cases） according to number table. Patients in the observation group were undertaken the neural navigation technology combined with DTI assisted surgery, the patients in the control group using the traditional surgical removal of the tumor. The total resection rates in two groups were compared. Functional status were assessed by Karnofsky score（KPS score）. Results 8 cases（44.44%） in the control group were totally removed of cancer patients,while resection of cancer patients in the observation group was 15 cases（83.33 %）, the difference was statistically significant（x2= 5. 899 7,P〈0.05）. 10 patients（55.56%） in control group of KPS score ≥70 points,while in the observation group were 16 cases（88.89 % ） of KPS score ≥70 points, the difference was statistically significant（x2 = 4. 984 6, P〈0.05）. There was statistically significant difference on KPS score in two groups（P〈0.05）. 14 cases of asymptomatic survival, two cases of relapse,and two cases with seizures in the observation group during follow-up, while 9 patients with asymptomatic survival,4 cases of relapse, 2 cases of death, 3 cases with long-term incomplete motor dysfunction in the control group during follow-up. Conclusion The results show that neuronavigation combine with diffusion tensor imaging can confirm the tumor resection,it can improve total resection rate of brain function area, and improve postoperative functional status. It can protect brain function while the maximum range to remove the tumor.

关 键 词：神经导航 DTI技术 大脑功能区肿瘤 

分 类 号：R739.41[医药卫生—肿瘤]