CAJ | 학술논문

目的探讨低场强iMRI环境下神经电生理监测(IOM)的操作特点与临床初步体会.方法分析9例功能区脑肿瘤10M及iMRI的联合应用情况.采集IOM基线,与iMRI环境下的波形比较;记录iMRI影像畸变及电刺激相关不良事件.术后早期复查MRI评估肿瘤切除隋况.结果 9例行IOM均获得稳定波形.1例前置放大器冈磁电效应损坏,未观察到热损伤或电极移动损伤.iMRI 7例局部信号缺失;3例发现肿瘤残余.术后随访MRI 7例全切,2例次全切除,与iMRI判断一致.结论低场强iMRI环境下,IOM可获得稳定波形.二者联合应用,有助于病变安全切除.
목적 탐토저장강iMRI배경하신경전생리감측(IOM)적조작특점여림상초보체회.방법 분석9례공능구뇌종류10M급iMRI적연합응용정황.채집IOM기선,여iMRI배경하적파형비교;기록iMRI영상기변급전자격상관불량사건.술후조기복사MRI평고종류절제수황.결과 9례행IOM균획득은정파형.1례전치방대기강자전효응손배,미관찰도열손상혹전겁이동손상.iMRI 7례국부신호결실;3례발현종류잔여.술후수방MRI 7례전절,2례차전절제,여iMRI판단일치.결론 저장강iMRI배경하,IOM가획득은정파형.이자연합응용,유조우병변안전절제.
Objective To evaluate methodological aspects and preliminary clinical experience in 9 patients for intraoperative neurophysiological monitoring(IOM)in low-field intraoperative MRI(iMRI) system.Methods Data of 9 patients with intracerebral neoplasms in eloquent areas underwent tumor resection assisted by both iMRI and IOM were reviewed.Before the maglmt was brought out from the cabinet.we got the "baseline"IOM waveform in order to compare with the wavoform within iMRI environment. Meanwhile.adverse effects caused by electrical stimulation and image distortions of iMRl were recorded.Early high-field MRI was performed to evalante the tumor resection after the operation.Results Combined use of iMRI and direct electrical stimulation (DES) Was performed in all patients.IOM could be performed with good quality within a low-field iMRI environment.However.a preamplifier was damaged during the monitoring in 1 case for magnetoelectric effect.The damage caused by heat or electrode movement was not observed.For image quality,signal voids were observed in the image areas which were very close to the scalp electrodes in 7 patients.Further tumor resection was performed in 3 patients for residual tumor demonstrated by iMRI.The completion of presurgical planning was achieved in all cases(7 total resection.2 subtotal resection).The iMRI findings were consistent with postoperative hish-field imaging in all cases.Conclusions IOM can be performed with standard quality within a low-field iMRI environment.The combined use of low-field open iMRI and IOM allows tumor resection control and continuous functional monitoring.