吲哚菁绿荧光血管造影在脑肿瘤手术中的应用

Application of indocyanine green fluorescence angiography in surgery for brain tumors

目的探讨吲哚菁绿荧光血管造影在脑肿瘤手术中的作用。方法回顾性分析102例脑肿瘤病人的临床资料,其中低级别胶质瘤14例,高级别胶质瘤56例,脑膜瘤18例,转移瘤12例,血管网状细胞瘤2例。所有病人均行吲哚菁绿荧光血管造影,并在整合荧光造影的手术显微镜下切除肿瘤。结果本组共实施吲哚菁绿荧光血管造影205次,均成功完成;单次造影所需时间约4 min,术中可实时辨认造影血管的动脉期、毛细血管期和静脉期。术后出现一过性皮疹1例,所有病人均未出现严重过敏现象。结论在肿瘤切除前,吲哚菁绿荧光血管造影可实时动态观察瘤内和瘤周血管的血流情况;肿瘤切除后,可观察保留血管的情况。吲哚菁绿荧光血管造影是一种快速、简便和安全的造影方法。

Objective To investigate the application ofindocyanine green （ICG） fluorescence angiography during of brain tumor surgery. Methods Clinical data of 102 patients with brain tumors were analyzed retrospectively, including low-grade glioma in 14 cases, high-grade glioma in 56, meningioma in 18, metastasis in 12 and hemangioblastoma in 2. The ICG fluorescence angiography was performed in all the patients, and the tumors were resected under the surgical microscope with fluorescein angiography. Results ICG fluorescence angiography was performed 205 times, and all the procedures were successful. The time of single angiography was about 4 min, and the arterial phase, capillary phase and venous phase of angiographical vessels were identified at real time in the operation. Transient rash occurred in 1 case postoperatively and no serious allergy occurred. Conclusions ICG fluorescence angiography can provide real time blood flow situation of the tumoral and peritumoral vessels before resection, and can observe the situation of vessels preserved after tumor resection, thus being a fast, convenient and safe angiographic method.