术中磁共振在岛叶胶质瘤手术中的应用

Application of intraoperative magnetic resonance imaging in insular glioma surgery

目的 评估超高场强术中磁共振（intraoperative magnetic resonance imaging,iMRI）联合功能神经导航对于岛叶胶质瘤切除程度以及术后神经功能的影响.方法 选择2013年1月至2014年4月间,接受iMRI联合功能神经导航手术的38例岛叶胶质瘤患者,对切除程度及术后并发症等进行评价.结果 20（53％）位患者通过iMRI发现肿瘤有残留,17例患者扫描后再次进行切除.进一步切除使肿瘤残留容积从17.9 mi减少到1.1 ml（P =0.0002）,切除程度从96.9％提高到99.2％ （P =0.0013）.24％的患者术后出现神经功能障碍.结论 联合iMRI和功能神经导航手术安全有效,可以显著提高岛叶胶质瘤的切除程度,保护神经功能.

Objective To evaluate the effects of ultrahigh-field intraoperative magnetic resonance imaging （iMRI） in combination with function neuronavigation on extent of resection of insular glioma and postoperative neurological function.Methods Thirty-eight patients with insular glioma who received iMRI in combination with functional neuronavigation surgery were enrolled between January 2013 and April 2014.The extent of resection and postoperative complications were evaluated.Results Residual tumors in 20 patients （53%） were found by iMRI.They were removed again in 17 patients after scanning.After further resection,the residual tumor volume was decreased from 17.9 ml to 1.l ml （P =0.0002）.The extent of resection increased from 96.9% to 99.2% （P =0.0013）.24% of patients had neurological dysfunction after procedure.Conclusion iMRI in combination with functional neuronavigation surgery is safe and effective.It significantly increases the extent of resection of insular glioma and protects neurological function.