术中超声检查在胶质母细胞瘤切除的疗效分析  

Analysis of the role of intraoperative ultrasonography in glioblastoma resection

作　　者：郭少春 王元 冀培刚 寇云鹏 刘竞辉 韩宇 李晓琴 强小鹏 王佳 王樑 Guo Shaochun;Wang Yuan;Ji Peigang;Kou Yunpeng;Liu Jinghui;Han Yu;Li Xiaoqin;Qiang Xiaopeng;Wang Jia;Wang Liang(Department of Neurosurgery,Tangdu Hospital,Air Force Medical University,Xi'an,Shaanxi,710038;Department of Diagnostic Radiology,Tangdu Hospital,Air Force Medical University,Xi'an,Shaanxi,710038;Department of Diagnostic Ultrasound,Tangdu Hospital,Air Force Medical University,Xi'an,Shaanxi,710038)

机构地区：[1]空军军医大学唐都医院神经外科,陕西西安710038 [2]空军军医大学唐都医院放射诊断科,陕西西安710038 [3]空军军医大学唐都医院超声诊断科,陕西西安710038

出　　处：《中国微侵袭神经外科杂志》2025年第1期31-37,共7页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：陕西省杰出青年科学基金(编号:2023-JC-JQ-68);陕西省高校青年创新团队(编号:2022-61)。

摘　　要：目的探讨术中超声检查在胶质母细胞瘤(glioblastoma,GBM)切除的价值。方法回顾性分析136例GBM患者病例资料。均使用术中超声辅助手术切除GBM。收集肿瘤位置及大小、手术前后MRI结果,术中超声、术后病理结果和随访信息。通过术中超声资料和术后MRI对比,确定肿瘤切除程度与是否存在残留。结果术中超声指导下肿瘤全切组114例,肿瘤残留组22例。与肿瘤全切组患者相比,肿瘤残留组患者术前肿瘤体积更大(P<0.001)。肿瘤全切组比肿瘤残留组无进展生存期[(progression free survival,PFS)7个月vs.4个月,P=0.013]和总生存期[(overall survival,OS)12个月vs.7个月,P=0.008]显著延长。进一步分析发现,术中超声辅助GBM全切率为78.68%,对残留肿瘤正确判断率为73.08%,术后MRI提示肿瘤残留体积与术中超声所示残留体积相关性很高(R^(2)=0.9392)。结论术中超声的使用有助于GBM患者获得更高的肿瘤全切率,更少的肿瘤残留和更长的生存时间。Objective To explore the value of intraoperative ultrasonography in the resection of glioblastoma(GBM).Methods The clinical data of 136 patients with GBM were analyzed retrospectively.Intraoperative ultrasonography was used to assist in the surgical resection of GBM in all patients.Information on tumor location and size,preoperative and postoperative MRI results,intraoperative ultrasonography findings,postoperative pathological results,and follow-up information were collected.By comparing intraoperative ultrasonography data with postoperative MRI,the extent of tumor resection and the presence of residual tumor were determined.Results There were 114 cases in the total tumor resection group and 22 cases in the residual tumor group(residual tumors).Compared with the total tumor resection group,the preoperative tumor volume of the patients in the tumor residual group was larger(P<0.001).There were significant differences in progression-free survival(PFS)and overall survival(OS)between the two groups,with the PFS(7 months vs.4 months,P=0.013)and OS(12 months vs.7 months,P=0.008)significantly longer in the total tumor resection group.Further analysis showed that the total resection rate of intraoperative ultrasound-assisted GBM was 78.68%,and the correct judgment rate of residual tumor was 73.08%,and the residual tumor volume shown by postoperative MRI showed a high correlation(R^(2)=0.9392).Conclusion The use of intraoperative ultrasound can help GBM patients achieve higher tumor resection rate,less tumor residual and longer survival time.

关 键 词：胶质母细胞瘤 超声检查 术中 切除程度 疗效分析 

分 类 号：R739.41[医药卫生—肿瘤] R730.264[医药卫生—临床医学]