术前MRI 3D重建定位结合术中肌电监测技术治疗臂丛神经鞘瘤  

Preoperative 3D reconstruction of MRI combined with intraoperative neurophysiological monitoring in the treatment of brachial plexus neurilemmoma

作　　者：倪晓[1] 李培丰 林晓克 张怀保[1] 邱海胜[1] 王健[1] Ni Xiao;Li Peifeng;Lin Xiaoke;Zhang Huaibao;Qiu Haisheng;Wang Jian(Department of Hand Surgery,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院手外科,温州325000

出　　处：《中华手外科杂志》2020年第4期287-289,共3页Chinese Journal of Hand Surgery

基　　金：温州市科学技术局公益性科技计划项目(Y20150235)。

摘　　要：目的探讨利用术前MRI 3D重建技术定位臂丛神经鞘瘤,并结合术中肌电监测在臂丛神经鞘瘤手术治疗中的应用价值。方法分析16例良性臂丛神经鞘瘤病例,术前均行MRI检查,并利用3D重建技术定位肿瘤,术中显露神经鞘瘤后,均在术中肌电监测下确定安全区,从安全区进入,显微切除肿瘤。结果16例均完全切除肿瘤,术后均未发生明显并发症。随访3~40个月,肿瘤无复发,预后良好。结论术前MRI 3D重建技术定位臂丛神经鞘瘤,术中行肌电监测,确定安全区后进行神经鞘瘤的手术切除,有助于提高手术的安全性,避免并发症的发生。Objective To explore the application value of preoperative 3D reconstruction of MRI in localization of brachial plexus neurilemmoma combined with intraoperative neurophysiological monitoring in the surgical treatment of brachial plexus neurilemmoma.Methods Sixteen cases of benign brachial plexus neurilemmoma were analyzed.MRI was performed before the operation,and the tumors were located by 3D reconstruction technique.After the neurilemmoma was exposed during the operation,the safe area was determined by neurophysiological monitoring,and the tumors were removed by microsurgery.Results All the neurilemmoma of the 16 cases were completely resected and no obvious complications occurred.The follow-up period ranged from 3 to 40 months.There was no recurrence and the prognosis was good.Conclusion The preoperative localization of brachial plexus neurilemmoma with 3D reconstruction of MRI,intraoperative neurophysiological monitoring and surgical resection of neurilemmoma after determining the safe area are helpful to improve the safety of operation and avoid complications.

关 键 词：臂丛 神经鞘瘤 术中肌电监测 磁共振成像 

分 类 号：R739.43[医药卫生—肿瘤]