术中超声结合导航在神经外科手术中的应用

Application of neuronavigation combined with intra-operative ultrasound in neurosurgical operations

目的探讨超声结合导航的影像引导系统在神经外科手术中的作用及应用价值。方法回顾130例在超声结合神经导航下接受手术患者的临床资料。其中海绵状血管瘤50例,动静脉畸形42例,胶质瘤22例,转移瘤5例,室管膜瘤2例,其他病变9例。结果本组病变全切率为95.4%。导航误差1.2～3.5mm(平均2.1mm),发生较明显结构性影像漂移14例(10.8%);超声对本组病变均能良好显示。结论超声结合导航适合于血管畸形、皮层下脑内肿瘤及脑室内肿瘤的手术。神经导航和术中超声是目前最为常用的两种神经外科术中影像引导系统,各自有不能被取代的特点,同时也存在不可避免的缺陷。合理使用超声和导航系统,才能更好地发挥二者的优势。

Objective To analyze the benefit of the application of neuronavigation combined with intra - operative ultrasound in neurosurgical operations. Methods Totally 130 cases underwent surgical treatment applied with neuronavigation and intra - operative ultrasound, were analysed retrospectively, in which there were 80 males and 50 females, and the age arranged from 6 to 72 （ average age of 32.7 years old）. This group included 50 cavernous angiomas, 42 arteriovenous malformations, 22 gliomas, 5 metastatic tumors, 2 ependymomas and 9 other intracranial masses. Results 95.4% of the masses were removed totally. The average relative accuracy of neuronavigation was 2. lmm, and structural brain - shifts occurred in 14 cases（ 10.8% ）. All masses were well displayed by intra - operative ultrasound. Conclusions Neuronavigation combined with intra - operative ultrasound produces most benefit of surgery for vascular malformations, subcortical tumors and cerebral ventricular tumors.