功能性磁共振辅助神经导航手术治疗运动功能区病变

Functional MRI assisted neuronavigation guided surgery of intracranial tumorslocated in or near the motor cortex

目的研究功能性磁共振成像(fMRI)辅助神经外科导航系统在运动功能区病变手术中的应用价值。方法利用血氧水平依赖性测量(BOLD)成像技术,对14例运动功能区病变病人(胶质瘤11例,脑膜瘤2例,转移癌1例)行fMRI检查,将有关数据及图像进行相关分析处理,得到活化功能区图像,将功能像与结构像融合,输入神经外科导航系统,术中进行功能区定位,指导手术。结果病人术中病灶影像均获得等体积全切除,术后神经功能障碍未加重。结论fMRI检查可以为功能区病变术前手术计划的制定提供有价值的信息,结合导航系统,可在术中精确定位功能区,避免损伤,降低致残率。

Objective To assess the value of functional MRI assisted neuronavigation surgery of intracranial tumors located in or near the motor cortex. Methods 14 cases with cerebral tumors (11 cases were gliomas, 2 meningiomas, 1 metastatic carcinoma) of the motor cortex were scanned by functional MRI preopertively. The sites of neuronal activation were identified by correlation analysis and normal MRI, the data were transferred into the neuronavigation system, the motor cortex was mapped, then to guide the neurosurgical procedures. Results 14 central area tumors were totally resected without leaving any neurological deficit. Conclusion Functional MRI can provide valuable information for preoperative planning. Accompanied with the neuronavigation system, can accurately localize the intracerebral lesions of eloquent brain, and to reduce the morbidity for clearance of the lesions.