基于DICOM模式与神经导航技术在儿童脑干胶质瘤中的应用  

Application of DICOM and neuronavigation technology in children with brain stem glioma

作　　者：魏宜功 王诚 周焜 刘窗溪[2] 惠旭辉[3] WEI Yigong;WANG Cheng;ZHOU Kun;LIU Chuangxi;HUI Xuhui(Department of Neurosurgery,Jinyang Hospital Affiliated to Guizhou Medical University(Guiyang Second People's Hospital),Guiyang,Guizhou 550004,China;Department of Neurosurgery,Guizhou Provincial People's Hospital,Guiyang,Guizhou 550002,China;Department of Neurosurgery,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]贵州医科大学附属金阳医院(贵阳市第二人民医院)神经外科,贵州贵阳550004 [2]贵州省人民医院神经外科,贵州贵阳550002 [3]四川大学华西医院神经外科,四川成都610041

出　　处：《中国医学工程》2024年第9期23-28,共6页China Medical Engineering

基　　金：贵州省卫生健康委科学技术基金项目(gzwjkj2020-1-104);贵阳市高层次创新型青年卫生人才培养项目(2021筑卫健科技合同字第15号)。

摘　　要：目的探讨基于DICOM模式融合神经导航技术在儿童脑干胶质瘤显微手术中的应用价值。方法回顾性收集2018年1月至2022年12月贵州医科大学附属金阳医院神经外科儿童脑干胶质瘤21例,术中采用头颅MRI原始数据DICOM模式通过计算机处理软件融合神经导航技术,结合术中实时电生理监测行脑干肿瘤切除术,术后判断病例的疗效。结果20例(95.2%)肿瘤近全切除,1例(4.8%)部分切除。术后症状短期内均有缓解,围手术期内无死亡病例。随访6~48个月,平均(35±10.1)个月,Karnofsky功能状态评分标准(KPS评分)术前及术后两者差异有统计学意义(P<0.05),随访期间有5例(23.8%)恶化,其中3例死亡,总体生存率61.9%(13/21)。结论DICOM模式融合神经导航技术能术中辅助确定脑干-肿瘤边界,电生理监测能保障患者神经功能,最大程度切除肿瘤。【Objective】To explore the application value of fusion neuronavigation technology based on DICOM model in children's brain stem glioma microsurgery.【Methods】Twenty-one cases of children with brain stem glioma in the Department of Neurosurgery of Jinyang Hospital Affiliated to Guizhou Medical University from January 2018 to December 2022 were retrospectively collected.DICOM mode of original head MRI data was adopted,neuronavigation technology was combined with computer processing software and real-time electrophysiological monitoring brain stem tumor resection,postoperative efficacy of the cases was evaluated.【Results】Twenty cases(95.2%)were completely resected and 1 case(4.8%)was partially resected.The postoperative symptoms were relieved in the short term,and there were no death cases during the period.The average follow-up was 35±10.1 months from 6 to 48 months.There was a statistically significant difference between preoperative and postoperative Karnofsky Performance Status(KPS)Scale scores.During the follow-up period,5 cases(23.8%)deteriorated,3 of them died,and the overall survival rate was 61.9%(13/21).【Conclusion】DICOM model fusion neuronavigation technology can assist in determining the brain stem-tumor boundary during surgery,and electrophysiological monitoring can guarantee the nerve function of patients and maximize tumor resection.

关 键 词：DICOM模式 神经导航 儿童 脑干胶质瘤 疗效 

分 类 号：R739.41[医药卫生—肿瘤]