神经导航系统在颅脑手术中的应用体会

Application of neuronavigation in microneurosurgery of patients with intracranial lesions

目的 探讨神经导航技术在颅内病变显微神经外科手术中的应用价值。方法 2 2例颅内肿瘤和血管性病变患者 ,经术前MRI和 (或 )fMRI检查 ,将影像数据输入计算机工作站进行三维重建和术前计划 ,标记病灶及其临近重要结构。术中神经导航引导下以显微神经外科技术切除病变 ,进行手术前后的临床和影像学评价。 2 2例患者中 ,脑膜瘤 9例 ,胶质瘤 3例 ,胆脂瘤 1例 ,海绵状血管瘤 5例 ,动静脉畸形 3例 ,转移瘤 1例。结果 18例病灶全切除 ,4例次全切除 ;1例术后发生偏瘫 ,其余无新增加神经功能障碍。结论 神经导航能有效指导手术入路 ,对术前计划和显微手术的术中引导有价值。

Objective To investigate the value of neuronavigation in microneurosurgery of intracranial lesions.Methods 22 cases of intracranial tumor and cerebrovascular malformation who underwent preoperative magnetic resonance imaging,and furthermore,some of them underwent functional magnetic resonance imaging.The data were transferred to the neuronavigation workstation.The tumor and eloquent regions nearby was lined out in colours,and reconstruction in a triplanar format as well as three-dimensionally was implemented.The lesions were removed under neuronavigating with microneurosurgical technique.Clinical and image evaluation of preoperation and postoperation were compared.The diagnosis of the 22 patients included 9 mengioma,3 gliomas,1 epidermoid cyst,5 cavernous angioma,3 AVM and 1 metastasis.Results In eighteen patients the tumour was removed completely,while the other four patients had residual tumor.All patients had no new neurological deficit expect one.Conclusion Neuronavigation has great value of preoperative planning and intraoperative guiding and can direct neurosurgical approach efficiently.