磁共振导航引导下的脑脓肿穿刺抽吸术

Interventional Magnetic Resonance Imaging Guided Drainage of Brain Abscess

目的开放式磁共振结合光学导航系统应用于神经外科,可以获得准确的手术定位、实时的对手术器械的引导和术中监控。我们对4例脑脓肿患者施行磁共振导航引导下穿刺抽吸术,探讨介入性磁共振用于脑脓肿治疗的初步经验、可能的并发症及在神经外科的应用前景。方法使用Philip公司的0.23T开放式磁共振扫描机结合iPath200光学导航系统,施行4例脑脓肿穿刺抽吸术。结果所有患者术后影像学资料证实脓肿腔体积缩小50％以上,1例小脑脓肿患者死亡,死亡原因为术前发生的多器官功能衰竭一直未得到纠正,其余患者神经功能缺损症状均有不同程度的改善,未发生手术所致并发症。

Objective The integration of open - MRI and optical navigation system can be used in neurosurgy for accurately lesion positioning, real - time tracting of surgical devices and intraoperative monitoring.4 cases of drainages of brain abscesses have been performed in our department and we evaluate our original clinical experience with this new technique.Methods An open- design0.23 T magne(Philip Co.)combined with iPath 200 optical navigation system was used for the 4 frameless MR - guided needle aspirations of brain abscesses. Results In all cases the technique resulted in successful placement of the needle within the target lesion to complete the treatment. Post - procedure MR scan displayed the volume of abscesses in all cases reduced by more than 50%. One of the patients suffered from cerebellar abscess died of multiple organs failure.The clinical menifestations in the other three patients improved evidently without complications induced by procedures.