3．0T术中磁共振在脑胶质瘤切除中的应用研究

3.0T intraoperative application of magnetic resonance in glioma resection

目的探讨3．0T高场强术中磁共振在脑胶质瘤手术切除中的应用价值。方法北京军区总医院自2011年1月至2013年12月收治152例脑胶质瘤患者．其中应用3．0TMRI及Brainlab神经导航系统辅助切除肿瘤67例[术中磁共振（iMRI组）]，单纯神经导航指导下切除肿瘤85例f对照组），回顾性分析患者的临床资料，比较患者的手术时间、肿瘤切除程度和预后情况。结果152例脑胶质瘤均成功切除。对照组和iMRI组患者的手术时间比较差异无统计学意义（P〉0．05）；iMRI组患者肿瘤全切60例，次全切除4例，大部切除2例，部分切除1例。对照组患者全切除61例，次全切除8例，大部分切除9例，部分切除7例，iMRI组患者肿瘤的切除程度较高，差异有统计学意义（P〈0．05）；iMRI组患者的预后良好率（94．03％）明显高于对照组（72．94％），差异有统计学意义（P〈0．05）；无磁共振不良事件发生、无感染患者。结论3．0T高场强术中磁共振神经导航技术有助于实时纠正术中脑移位误差，精确定位胶质瘤影像学边缘，指导临床最大程度切除胶质瘤，保留神经功能区．改善患者预后。

Objective To investigate the 3.0T high-field intraoperative MR imaging applications in surgical resection of gliomas. Methods One hundred and fifty-two patients with brain gliomas, admitted to our hospital from January 2011 to December 2013, were enrolled in our study; tumor resection was performed in 85 patients under the guidance of a simple neural navigation （control group） and 67 patients under intra-operative MRI neuronavigation （iMRI group）. A retrospective analysis was performed on the clinical data of the patients; tumor resection rate, surgical time and prognosis of the patients were analyzed and compared between the two groups. Results All the 152 patients were successfully performed tumor resection. Longer surgical time was needed in patients ofiMRI group than that in the control group, with significant difference （P〈0.05）. In the iMRI group, total resection was achieved in 60 patients, subtotal resection in 4, greatly partial resection in two, and partial resection in one; in the control group, total resection was achieved in 61 patients, subtotal resection in 8, greatly partial resection in 9, and partial resection in 7; the resection rate in the iMRI group was significantly higher than that in the control group （P〈0.05）. The good prognosis rate in the iMRI group （94.0%） was significantly higher than that in the control group （72.9%, P〈0.05）. No MRI-related adverse events or infected patients were noted. Conclusion 3.0T high-field intraoperative MRI technology helps intra-operative brain shift in real-time to correct the error, pinpoint glioma imaging edge to maximize clinical glioma resection, retain neurological areas and improve prognosis of the patients.