荧光素钠在高级别胶质瘤手术价值的研究

Research on the value of fluorescein sodium in high-grade glioma surgery

目的评价荧光素钠指导高级别脑胶质瘤手术切除的准确性。方法回顾性分析50例高级别脑胶质瘤病例资料,术前行增强MRI检查,术中在荧光素钠染色下指导手术切除肿瘤,术后行增强MRI、MRS检查,测量并比较胶质瘤术后术腔壁(a区)、肿瘤侧正常脑组织(b区)及对侧相应区域正常脑组织(c区)的Cho/Cr值及差异。结果 a区分别与b区、c区比较,差异有统计学意义(P<0.05);b区与c区比较,差异无统计学意义(P>0.05)。结论在高级别胶质瘤手术中,严格按照荧光素钠的染色范围切除肿瘤,不能全切除肿瘤,需在不影响功能的前提下扩大切除。

Objective To assess the accuracy of fluorescein sodium guidance for high-grade glioma surgery. Methods Clinical data of 50 patients with high-grade glioma were analyzed retrospectively. The preoperative and postoperative enhanced MRI and MRS were performed. Surgical resection of the tumor was carried out under guidance of sodium fluorescein staining. The postoperative Cho/Cr ratio of the wall of post-resection cavity （area a）, normal brain tissue on the tumor side （area b） and normal brain tissue in the corresponding area （area c） on the other side were measured and compared. Results There were statistically significant differences in Cho/Cr ratio between area a and area b or area c respectively （P 〈 0.05）, but no statistically significant difference between area b and area c （P 〉 0.05）. Conclusions In high-grade glioma surgery, the glioma can not be completely removed if the excision is limited in the extent of sodium fluorescein staining. An expanding excision is need under the premise that excision extent does not affect the function.