豆纹动脉的位置在岛叶胶质瘤手术中的重要性

Importance of the the lenticulostriate artery position to surgery for insular gliomas

目的探讨豆纹动脉位置在岛叶胶质瘤手术中的重要性。方法回顾性分析2008年1月至2012年3月行手术治疗的38例岛叶胶质瘤患者的临床资料,25例豆纹动脉位于肿瘤外侧(外侧组),13例豆纹动脉位于肿瘤内侧(内侧组)。结果外侧组肿瘤全切除17例(68.0%,17/25),近全切除4例,大部分切除4例;内侧组肿瘤全切除4例(30.8%,4/13),近全切除3例,大部分切除6例。两组肿瘤全切除率差异显著(P<0.05)。外侧组术后没有新发神经功能障碍,原有的神经功能障碍术后未加重;内侧组新发神经功能障碍4例(30.8%,4/13),神经功能障碍加重2例。两组术后神经功能障碍发生率差异显著(P<0.05)。结论术前明确岛叶肿瘤的解剖学特征,特别是豆纹动脉的位置对决定手术切除方式有重要价值。

Objective To explore the importance of the lenticulostriate artery position to total resection of insular gliomas. Methods The clinical data of 38 patients with insular gliomas, who underwent microsurgery from January, 2008 to March, 2012, were analyzed retrospectively. The MRI and DSA were performed to identify the positional relationship between the lenticulostriate artery and the tumors in 38 patients with insular gliomas. Results The lenticulostriate arteries ran laterally to the tumors in 25 patients （group A） and the lenticulostfiate arteries ran medially to the tumors in 13 patients （group B）. Of 25 patients in group A, 17 （68.0%） underwent total resection of the tumors, 4 （16.0%） subtotal and 4 （16.0%） greatly partial. Of 13 patients in group B, 4 （30.8%） underwent the total resection of the tumors, 3 （23.1%） subtotal and 6 （46.2%） greatly partial. The total resection rate was significantly higher in group A （68.0%, 17/25） than that （30.8%, 4/13） in group B （P〈O.05）. After surgery, the rate of new neurological deficits was significantly lower in group A （0） than that [30.8% （4/13）] in group B （P〈0.05）. Conclusion The lenticulostriate artery position is very important to total resection of the insular gliomas.