术中磁共振联合神经导航在丘脑胶质瘤手术中的应用

Application of intraoperative magnetic resonance imaging combined with neuronavigation for operation of thalamic gliomas

目的探讨术中磁共振(iMRI)联合神经导航在丘脑胶质瘤的应用价值。方法回顾性分析2014-01—2017-02应用3.0T术中磁共振联合神经导航的28例丘脑胶质瘤手术患者的临床资料,评估术后肿瘤切除程度及术后功能状态。结果 28例患者第一次iMRI扫描17例仍有病变残留,进行扩大切除9例达到完整切除,全切率从39.3%提高到71.4%,8例肿瘤边缘累及运动功能皮质或皮质脊髓束无法行完整切除。术后6个月28例丘脑胶质瘤患者神经功能改善者20例,无变化6例,下降2例。结论术中磁共振联合神经导航有助于提高丘脑胶质瘤手术精准性和安全性,提高肿瘤切除程度,最小限度减少脑功能损伤,为术后手术效果提供帮助。

Objective To explore the clinical value ofintraoperative magnetic resonance imaging (iMRI) combined with neuronavigation on the operation of thalamic gliomas. Methods The clinical data of a total of 28 patients with thalamic glioma underwent microsurgical operation from January 2014 to February 2017 were retrospectively analyzed,and all patients aided by 3.0T iMRI combined with neuronavigation.The extent of resection of tumors and postoperative functional status were evaluated. Results In the first iMRI scan of 28 patients,residual tumors in 17 patients,9 patients achieved complete resection after received further extended resection,the total resection rate increased from 39.3% to 71.4%, and 8 tumors were unable to complete resection due to tumor edge involvement in motor function cortex or corticospinal tract.Six months after surgery,the neurological function with thalamus glioma improved or kept no change in 26 cases,and 2 cases experienced neurological function decline. Conclusions iMRI combined with neural navigation is helpful to improve the accuracy and safety of surgery for thalamus glioma,maximize the degree of tumor resection, minimize the damage to brain function,and provide help for postoperative operation recovery.