术中磁共振成像联合神经导航在岛叶胶质瘤显微手术中的应用  

Application of intraoperative MRI combined with neuronavigation in microsurgical resection for insular glioma

作　　者：周权炜 夏力 何科君[1] 严圣 徐小平 李西西 黄正松[1] 张弩[1] ZHOU Q.uanwei;XIA Li;HE Kejun;YAN Sheng;XU Xiaoping;LI Xixi;HUANG Zhengsong;ZHANG Nu(Department of Neurosurgery, First Hospital Affiliated to Sun Yat-sen University, Guangzhou 510080;Department of Neurosurgery, First Hospital Affiliated to Guangxi Medical University, Nanning 530000, China)

机构地区：[1]中山大学附属第一医院神经外科,广州510080 [2]广西医科大学附属第一医院神经外科,南宁530000

出　　处：《中南大学学报（医学版）》2018年第4期383-387,共5页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(81772683)~~

摘　　要：目的:评估术中磁共振成像(intraoperative magnetic resonance imaging,i MRI)联合神经导航在切除岛叶胶质瘤中的应用价值。方法:回顾性分析2014年8月至2017年10月中山大学附属第一医院采用3.0T i MRI联合神经导航辅助手术的41例岛叶胶质瘤患者的临床资料,对切除程度、并发症及预后进行评价。结果:通过i MRI发现肿瘤次全切除21例,大部分切除20例;i MRI后再次切除。术后MRI示肿瘤全切16例,次全切18例,大部分切除7例。对比i MRI前后肿瘤切除程度,差异有统计学意义(P<0.05)。41例患者在3个月至3年的随访期间,症状有所好转。结论:i MRI联合神经导航可以及时纠正脑漂移,准确评估肿瘤切除程度,最大安全范围内切除岛叶胶质瘤。Objective： To evaluate the value of intraoperative magnetic resonance imaging（i MRI） combined with neuronavigation for the resection of insular gliomas.Methods： From August 2014 to October 2017 in the First Hospital Affiliated to Sun Yat-sen University, clinical data of 41 patients with insular glioma, who underwent the surgery assisted with 3.0 T iMRI and neuronavigation, were analyzed retrospectively, and the resection extent, complications and prognosis were evaluated.Results： Subtotal tumor resection was achieved in 21 patients and partial resection was done in 20 af ter i MRI scanning. After further resection, total tumor resection was achieved in 16 patients, subtotal resection in 18 and partial resection in 7. There was a statistical significant difference intumor resection between pre-i MRI and post-iMRI according to the Fisher test（P〈0.05）. In the follow-up from 3 months to 3 years, the symptoms of the 41 patients had improved.Conclusion： iMRI corrected the shift of brain. Neuronavigation can accurately and timely assess the degree of resecting tumor. The combination of neuronavigation with surgery can maximally and safely resect insular glioma.

关 键 词：胶质瘤 术中磁共振成像 神经导航 岛叶 

分 类 号：R739.4[医药卫生—肿瘤]