吲哚菁绿视频血管造影在中央沟区肿瘤切除术中的静脉保护作用  

Indocyanine green video angiography for venous protection during tumor resection in the central sulcus region

作　　者：马超[1] 仇尤佳 陈周青 朱昀[1] 王中[1] Ma Chao;Qiu Youjia;Chen Zhouqing;Zhu Yun;Wang Zhong(Department of Neurosurgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院神经外科,苏州215006

出　　处：《中华神经外科杂志》2025年第1期51-56,共6页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金(82171309)。

摘　　要：目的探讨吲哚菁绿视频血管造影(ICG-VA)FLOW800技术在中央沟区肿瘤切除术中的静脉保护作用。方法回顾性收集2020年1月至2023年10月在苏州大学附属第一医院神经外科接受手术治疗的中央沟区肿瘤患者的临床资料,共23例;其中脑膜瘤19例,转移瘤2例,胶质母细胞瘤2例。均采用ICG-VA FLOW800技术,在肿瘤切除术前明确肿瘤与中央沟静脉的关系,在肿瘤切除前、后评估中央沟静脉及瘤周引流静脉通畅情况。观察肿瘤切除情况、手术相关并发症,随访临床及影像学预后。采用Karnofsky功能状态(KPS)评分评估临床预后。结果23例患者术中显微镜下显示肿瘤均为完全切除;中央沟静脉及瘤周引流静脉均解剖保留。ICG-VA FLOW800分析证实,肿瘤切除后中央沟静脉回流通畅者21例(91.3%),回流受阻者1例;1例患者肿瘤切除前因肿瘤压迫导致瘤周血管闭塞、上矢状窦回流受阻,肿瘤切除后,中央沟静脉向上矢状窦回流,瘤周静脉血流通畅。术后术区渗血1例,肌力较术前下降2例,肺部感染1例,癫痫发作2例。术后随访时间[M(Q 1,Q 3)]为20(6,36)个月。至末次随访,KPS评分90分19例(82.6%),60~80分4例(17.4%);1例转移性腺癌患者肿瘤复发需再次行手术。结论ICG-VA FLOW800技术在中央沟区肿瘤切除术中有助于明确肿瘤与中央沟静脉的关系,在完整地切除肿瘤的同时可对静脉系统予以保护。ObjectiveTo investigate the role of indocyanine green video angiography(ICG-VA)in venous protection during resecting tumors in the central sulcus region.MethodsThe clinical data of 23 patients with tumors in the central sulcus region who underwent surgical treatment in the Department of Neurosurgery,the First Affiliated Hospital of Soochow University from January 2020 to October 2023 were retrospectively collected.Pathological examination showed 19 cases of meningioma,2 cases of brain metastasis,and 2 cases of glioblastoma.ICG-VA FLOW800 technology was employed in all those cases to clarify the relationship between the tumor and the central sulcus vein before tumor resection,and to assess the patency of the central sulcus vein and peritumoral drainage vein before and after tumor resection.Degree of resection,surgery-related complications,and follow-up clinical and imaging outcomes were investigated.The clinical outcome was assessed using the Karnofsky performance status(KPS)score.ResultsThe tumors of 23 patients were completely resected under intraoperative microscope;the central sulcus vein and peritumoral drainage vein were anatomically preserved.ICG-VA FLOW800 analysis confirmed that the central sulcus vein reflux after tumor resection was smooth in 21 cases(91.3%),and the reflux was obstructed in 1 case;1 case had peritumoral vascular occlusion and upper sagittal sinus reflux obstruction due to tumor compression before resection;after tumor resection,the central sulcus vein refluxed to the upper sagittal sinus and peritumoral venous blood flow was smooth.During the perioperative period,there was 1 case of rebleeding,2 cases of muscle strength decrease,1 case of pulmonary infection,2 cases of epileptic seizure,and 1 case of recurrence requiring a second operation.The postoperative follow-up time M(Q 1,Q 3)was 20(6,36)months.At the final follow-up,19 cases(82.6%)had a KPS score of 90,and 4 cases(17.4%)had a score of 60 to 80;1 patient with metastatic adenocarcinoma had tumor recurrence requiring reoperation.Con

关 键 词：脑肿瘤 中央沟区 荧光素血管造影术 吲哚花青绿 静脉保护 

分 类 号：R739.41[医药卫生—肿瘤]