立体定向辅助定位结合磁共振弥散张量手术治疗大脑功能区病变

Digital Thematic Information Imaging Assisted Stereotact Guided Surgery of Intracranial Lesions Located with Eloquent Brain Regions

目的:探讨脑功能区皮质下占位性病变的手术治疗方法。方法:对11例脑功能区脑功能区及其附近占位性病变利用立体定向辅助下定位结合磁共振弥散张量手术治疗疗效进行了回顾性分析。结果:病变位于中央前回7例,位于中央后回4例,经手术和病理诊断证实低级别胶质瘤6例,胶质增生2例,海面状血管瘤3例。术后随访6个月至1年,病变全切率为100%,所有病变未见复发,7例患者(63.4%)癫痫症状完全消失,4例患者(36.6%)口服抗癫痫药物的情况下控制发作,11例中8例(72.7%)神经功能与术前相比未加重,3例(37.3%)患者术后出现轻微偏瘫,经高压氧及康复锻炼后恢复。结论:立体定向辅助定位结合磁共振弥散张量切除功能区病变,定位准确,避免损伤椎体束。

Objective： To summarize the operativel effect of space occupying lesions located within eloquent brain regions. Methods： We retrospectively analyzed the operative effect of the 11 patients suffering for lesions located within eloquent brain regions useing digital thematic information imaging assisted Stereotact guided techniques operation.Results：The lesions located in precentral gyrus in 7 cases,postcentral gyrus in 4 cases. Pathological results show low grade astrocytoma in 6 cases,gliosis in 2 cases,cavernous angioma in 3 eases. The lesions were removed with the help of digital thematic information imaging assisted Stereotact guided and microscope. All the patients were followed 6 to 12 months after operation.The tumor did not recur in all patients.The seizure completely controlled in 7 cases （63.4%）and 4 cases（36.6%） by low dose of antiepileptic drugs ofter operation.The motor function of the limbs was worsen in 3 cases（37.3%）, who competely rehabilitated after hyperbaric oxygen treatment and functional exercise, and other patients （72.7%）were better than or the same as that before operation.Conclusions：It could accurately localized lesion and reduced neurological impaiments to remove the lesions located within eloquent brain region by digital thematic information imaging assisted stereotact guided techniques.