超声实时导航下射频消融治疗巨大脑膜瘤

Ultrasound-guided radiofrequency ablation for treatment of giant meningiomas

目的探讨超声实时导航下射频消融治疗在巨大脑膜瘤手术中的作用。方法回顾性分析2010年11月至2011年4月经开颅手术治疗的巨大脑膜瘤29例,术中行超声实时导航、造影,其中15例患者在肿瘤切除前应用射频消融治疗。观察指标包括临床症状变化以及并发症情况。结果超声实时导航可以从多种角度、各种切面清楚地观察到肿瘤的位置、形状、大小、边界及毗邻关系,可随时显示内部及周边大血管分布、走行情况。射频消融术后,肿瘤出现凝固性坏死,切除时瘤体出血明显减少。肿瘤全切25例(86.2%),大部分切除4例(13.8%)。大多数患者临床症状明显改善。术后病理诊断为脑膜瘤WHO I级27例,WHO II级2例。结论超声实时导航以及射频消融治疗对于提高巨大脑膜瘤的切除率,减少术中出血及术后并发症具有重要作用。

Objective To investigate the effect of ultrasound-guided radiofrequency ablation for the treatment of giant meningiomas.Methods A total of 29 patients with giant meningiomas treated by craniotomy from October 2010 to April 2011 were analyzed retrospectively.All the cases were performed intraoperative ultrasound and angiography,of which 15 cases underwent ultrasound-guided radiofrequency ablation before tumor removal.Clinical symptoms and complications were observed.Results Intra-operative ultrasound could display clearly the location,shape,size,and boundary of tumor and its relation to other tissues and demonstrate the vascular distribution in and around tumors.Coagulation necrosis formed following the radiofrequency ablation and almost no bleeding occurred during tumor resection.Gross total removal was achieved in 25 cases（86.2%） and partial removal was achieved in 4 cases（13.8%）.Clinical symptoms were improved significantly.There were 27 cases of WHO grade I and 2 cases of WHO grade II meningiomas.Conclusion Intra-operative ultrasound and radiofrequency ablation are helpful in increasing resection rate,decreasing intraoperative bleeding and post-operative complications in resection of meningiomas.