脑磁图定位在功能区肿瘤手术中的应用

Application of magnetoencephalography localization in brain tumor surgery

目的探讨脑磁图定位在手术治疗脑功能区肿瘤中的作用。方法2003年1月至2005年4月收治36例脑皮层运动区或附近肿瘤患者,其中脑膜瘤19例,神经上皮肿瘤14例(低度恶性胶质瘤9例,高度恶性胶质瘤5例),转移性腺癌2例,海绵状血管瘤1例。常规行影像学和脑磁图检查,在横轴位及冠状位上行功能区定位,术前和术后功能区进行临床和影像学评价。结果本组36例患者脑磁图显示患侧功能区均发生不同程度的移位和变形,对34例患者肿瘤全切,术后影像学显示功能区保存良好,神经功能障碍完全恢复正常19例,同术前15例,加重2例。结论脑磁图是无创性功能区定位,可确定肿瘤与功能区位置关系,对脑肿瘤的手术前方案制定和功能区保护具有重要的指导意义。

Objective To evaluate the applied value of （ MEG ） localization in microsurgery of brain tumors in the region of motor cortex. Methods From January 2003 to April 2005, 36 patients with 19 meningomas,14 gliomas,2 metastases and 1 cavernous angioma underwent MEG and MRI before operation. These individualized functional brain maps were integrated into a neuronavigation system. Preoperative mapping of somatosensory and/or motor cortex was performed, and sites were compared, and all tumors were resected microsurgerically. Results A space-occupying lesion could change the region of motor cortex in all the patients. Thirty-four cases were resected totally. The patient＇s myodynamia after operation improved in 19 cases, unchanged in 15 cases, descended in 2 cases. Conclusions MEG is an effective localization method of function, providing the relationship between the region of motor cortex and the tumor. And it is valuable for accurate planning in the treatment of brain tumors in the region of motor cortex.