中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2011年
8期
683-687
,共5页
吴劲松%朱凤平%庄冬晓%姚成军%邱天明%路俊锋%杨忠%施建兵%黄峰平%毛颖%周良辅
吳勁鬆%硃鳳平%莊鼕曉%姚成軍%邱天明%路俊鋒%楊忠%施建兵%黃峰平%毛穎%週良輔
오경송%주봉평%장동효%요성군%구천명%로준봉%양충%시건병%황봉평%모영%주량보
神经胶质瘤%垂体肿瘤%术中磁共振成像
神經膠質瘤%垂體腫瘤%術中磁共振成像
신경효질류%수체종류%술중자공진성상
Glioma%Pituitary neoplasms%Intraoperative magnetic resonance imaging
目的 探讨3.0 T术中磁共振成像(iMRI)导航在神经外科手术应用的临床价值.方法 回顾性分析2010年9月至2011年3月,在具备诊断和手术功能的"3.0 T iMRI数字一体化神经外科手术中心"施行的各类颅脑手术122例,包括临床资料、iMRI实时影像导航对手术进程和手术结果的影响等.结果 122例患者手术室内扫描2～4次,平均2.6次.各种扫描图像质量皆优良.iMRI技术使脑胶质瘤(60例)手术全切除率从71.7%提高到90.0%,患者的近期致残率为6.7%,远期致残率3.3%.iMRI技术使垂体大腺瘤(29例)手术全切除率从75.9%提高到93.1%.未发生与应用iMRI数字一体化神经外科手术有关的并发症(如感染等).同期完成2500余人次MRI诊断性检查.结论 3.0 T iMRI神经导航的应用,为脑胶质瘤与垂体大腺瘤手术进程的实时引导、切除范围的精确判断以及脑功能与代谢信息的定量分析提供了客观依据,真正实现了脑肿瘤的最大程度安全切除.
目的 探討3.0 T術中磁共振成像(iMRI)導航在神經外科手術應用的臨床價值.方法 迴顧性分析2010年9月至2011年3月,在具備診斷和手術功能的"3.0 T iMRI數字一體化神經外科手術中心"施行的各類顱腦手術122例,包括臨床資料、iMRI實時影像導航對手術進程和手術結果的影響等.結果 122例患者手術室內掃描2～4次,平均2.6次.各種掃描圖像質量皆優良.iMRI技術使腦膠質瘤(60例)手術全切除率從71.7%提高到90.0%,患者的近期緻殘率為6.7%,遠期緻殘率3.3%.iMRI技術使垂體大腺瘤(29例)手術全切除率從75.9%提高到93.1%.未髮生與應用iMRI數字一體化神經外科手術有關的併髮癥(如感染等).同期完成2500餘人次MRI診斷性檢查.結論 3.0 T iMRI神經導航的應用,為腦膠質瘤與垂體大腺瘤手術進程的實時引導、切除範圍的精確判斷以及腦功能與代謝信息的定量分析提供瞭客觀依據,真正實現瞭腦腫瘤的最大程度安全切除.
목적 탐토3.0 T술중자공진성상(iMRI)도항재신경외과수술응용적림상개치.방법 회고성분석2010년9월지2011년3월,재구비진단화수술공능적"3.0 T iMRI수자일체화신경외과수술중심"시행적각류로뇌수술122례,포괄림상자료、iMRI실시영상도항대수술진정화수술결과적영향등.결과 122례환자수술실내소묘2～4차,평균2.6차.각충소묘도상질량개우량.iMRI기술사뇌효질류(60례)수술전절제솔종71.7%제고도90.0%,환자적근기치잔솔위6.7%,원기치잔솔3.3%.iMRI기술사수체대선류(29례)수술전절제솔종75.9%제고도93.1%.미발생여응용iMRI수자일체화신경외과수술유관적병발증(여감염등).동기완성2500여인차MRI진단성검사.결론 3.0 T iMRI신경도항적응용,위뇌효질류여수체대선류수술진정적실시인도、절제범위적정학판단이급뇌공능여대사신식적정량분석제공료객관의거,진정실현료뇌종류적최대정도안전절제.
Objective To report the preliminary experience in clinical application of 3.0 T intraoperative magnetic resonance imaging (iMRI) neuronavigation system in China. Methods From September 2010 to March 2011, a consecutive series of 122 patients with intracranial lesions underwent operations in guidance with 3.0 T iMRI. A retrospective analysis was conducted regarding clinical efficiency.Results Among 122 procedures, the numbers of intraoperative scanning were 2-4 times with an average of 2.6.The qualities of images were excellent. Due to the discovery and further possibility of resection of residual tumors, the ratio of gross total resection was increased from 71.7% to 90.0% in cerebral gliomas(n =60), while from 75.9% to 93.1% in macroadenomas (n =29).There were 6.7% of all patients occurred postoperative paralysis, but only 3.3% of patients had persistent paralysis at 1-2months follow-up.There was no iMRI-related adverse event occurred. During the same period, more than 2500 patients underwent diagnostic MRI scanning. Conclusions 3.0 T iMRI neuronavigation system provides high-quality intraoperative structural, functional and metabolic images for real time tumor resection control and accurate functional preservation, resulting in an improvement in maximal safe brain surgery.The system is cost-effective.
