功能区胶质瘤术中磁共振联合神经导航技术的应用

Application of iMRI combined with neuronavigation in functional areas glioma surgery

目的探讨在功能区胶质瘤手术中磁共振（iMRI）联合神经导航技术的应用。方法选择经iMRI联合神经导航手术的87例功能区胶质瘤患者，对其全切率、切除程度及术后神经功能进行评价。结果87例患者使用iMRI联合导航系统后，初次全切率为24.32%（20/87），初次切除程度（76.89±27.18）%。最终全切率59.45%（29/87），最终切除程度（92.39±12.31）%，差异有统计学意义（P〈0.05）。随访6个月，82例（94.60%）患者症状较前缓解，5例（5.40%）患者较术前加重且出现永久性神经功能障碍。Karnofsky评分术前1 d（78.51±11.09）分、术后10 d（78.51±13.37）分，差异未见统计学意义（P〉0.05）。结论iMRI联合神经导航的应用可提高患者功能区胶质瘤的病变切除率、改善患者预后。

ObjectiveTo investigate the application experience of intraoperative MRI combined with neuronavigation in functional areas glioma surgery.MethodsEighty-seven patients who accepted the intraoperative MRI and functional neuronavigation were selected. The microsurgery assisted by intraoperative MRI and neuronavigation was performed in 87 patients with tumors in the functional areas glioma. The extent of resection, the rate of total removal and postoperative neurological function was evaluated.ResultsAmong the 87 patients, after application of high field intraoperative MRI combind with neuronavigation, the primary total removal of tumor rate was 24.32% （20/87）, the primary degree of resection was （76.89%±27.18）%. Eventually, the total removal of tumor rate was 59.45% （29/87）, final degree of resection was （92.39%±12.31）%, the differences were significant （P〈0.05）. After 6 months of follow-up, the symptom relieved in 82 patients（94.6%）, and the symptom was worse in 5 patients and appeared neurological dysfunction. The preoperative Karnofsky score was （78.51±11.09） and postoperative Karnofsky score was （78.51±13.37）, the difference was not significant （P〉0.05）.ConclusionsThe application of high field intraoperative MRI combind with neuronavigation can enhance the rate of resection in functional areas glioma surgery and improve the prognosis of patients.