多模态神经导航系统在颅底脊索瘤神经内镜下手术中的应用  

Clinical application of multimodal neuronavigation system to neuroendoscope-assisted neurosurgery for skull base chordomas

作　　者：赵君爽 王鑫[1] 陈炼 李龙[1] 周锦鹏[1] 景治涛[1] ZHAO Jun-shuang;WANG Xin;CHEN Lian;LI Long;ZHOU Jin-peng;JING Zhi-tao(Department of Neurosurgery,The First Affiliated Hospital,Chinese Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院神经外科

出　　处：《中国临床神经外科杂志》2019年第6期324-326,共3页Chinese Journal of Clinical Neurosurgery

基　　金：国家自然科学基金(81101917)

摘　　要：目的探讨多模态神经导航系统在颅底脊索瘤神经内镜下切除术中的临床应用效果。方法回顾性分析2009年1月至2019年1月神经内镜下手术切除的124例颅底脊索瘤的临床资料。76例在多模态神经导航系统辅助下手术(多模态组),48例无术中影像学引导下手术(对照组)。结果术后1个月内复查MRI判断肿瘤切除程度:多模态组肿瘤全切除58例(76.32%),部分切除18例(23.68%);对照组肿瘤全切除25例(52.08%),部分切除23例(47.92%)。多模态组肿瘤全切除率明显高于对照组(P<0.01)。多模态组术后并发症发生率(10.53%,8/76)明显低于对照组(29.17%,14/48;P<0.01)。结论多模态神经导航系统通过多图像融合和三维重建,实时引导指示术中病变与邻近神经血管结构的空间关系,能显著提高颅底脊索瘤的全切除率,降低术后并发症发生率。Objective To explore the clinical application of multimodal neuronavigation system(MMNS)to neuroendoscopeassisted neurosurgery for skull base chordomas and its curative effects.Methods The clinical data of 124 patients with skull base chordomas,of whom,76(MMNS group)underwent neuroendoscope-assited neurosurgery with the help of MMNS and 48(control group)without the help of MMNS from January,2009 to January,2019,were analyzed retrospectively.The surgical outcomes and postoperative complications were compared between the two groups.Results The tumors were completely resected in 25 patients(52.08%)of the control group and in 58 patients(76.32%)of MMNS group,The rate of the total removal of the chordomas was significantly higher in MMNS group than that in the control group(P<0.01).The postoperative complications occurred in 8 patients(10.53%)of MMNS group and 14 patients(29.17%)of the control group.The rate of the occurrence of the postoperative complications was significantly higher in the control group than that in MMNS group(P<0.01).Conclusions MMNS with multi-image fusion and three-dimensional reconstruction may show the spatial relationship between the lesion and adjacent neurovascular structure in real-time,and it is very helpful to the increase in rate of the total resection of skull base chordomas and the decrease in the postoperative complications.

关 键 词：颅底脊索瘤 手术 神经内镜 多模态神经导航系统 三维重建 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]