新型无框架立体定向系统VarioGuide在颅内病变穿刺活检中的初步应用

Implementation of VarioGuide in stereotactic brain biopsy： a preliminary experience

目的 评价新型无框架立体定向系统VarioGuide在颅内病变穿刺活检中的应用价值。方法 2011年11月至2012年4月解放军总医院神经外科15例颅内病变患者，接受VarioGuide联合多模态神经导航辅助下的立体定向穿刺活检。术中磁共振（iMRI）用于验证活检的准确性。记录不良事件、手术时间、手术结果及术后并发症。结果 所有病例均成功实施了VarioGuide联合多模态神经导航辅助下的立体定向穿刺活检，无VarioGuide相关不良事件。手术平均耗时（65±8）min，iMRI证实全部穿刺位点与预设靶点完全吻合。术后全部标本均获得病理诊断，无死亡或其他术后并发症。结论 VarioGuide联合多模态神经导航是一种准确、安全、高效的技术手段，能够在不增加术后神经功能障碍的前提下，提高活检手术的阳性诊断率。

Objective To evaluate the clinical value of VarioGuide in stereotactic brain biopsy. Methods Fifteen patients with brain lesions underwent frameless stereotactic brain biopsy guided by VarioGuide and multimodal neuronavigation. Intraoperative magnetic resonance imaging （iMRI） was used to confirm the accuracy of biopsy. And the VarioGuide-related adverse events, operative duration, surgical outcomes and postoperative complications were recorded respectively. Results In all patients, VarioGuide and multimodal neuronavigation were successfully integrated into the biopsy procedure. No VarioGuide- related adverse events were reported. The mean operative duration was （65 ± 8 ） min. The biopsy accuracy was confirmed by iMRI in all cases. And the postoperative histological diagnostic rate was 100%. No mortality and morbidity occurred postoperatively. Conclusion The combined approach of VarioGuide and multimodal neuronavigation is accurate, safe and efficient. It may improve the histological diagnostic rate without postoperative neurological deficits in stereotactie brain biopsy.