CAJ | 학술논문

目的评价高场强术中磁共振(iMRI)对低级别胶质瘤切除程度的影响.方法 59例低级别胶质瘤患者接受高场强iMRI联合功能神经导航下显微手术,分别于首次和末次iMRI扫描后计算肿瘤切除率和切除程度.于术前、术后及随访时评估神经功能.结果所有病例均成功实施iMRI与功能神经导航.首次iMRI发现术者对21例(35.6％)肿瘤的全切率发生误判.首次iMRI发现17例(28.8％)肿瘤残留,继续切除使8例(13.6％)得到全切.iMRI使切除程度从首次扫描后的(90±15)％提高到末次扫描后的(94±12)％(P＜0.01).在肿瘤继续切除的17例患者中,切除程度从(78±17)％提高至(91±12)％(P＜0.01).3个月随访时2例(3.4％)遗留神经功能障碍.结论 iMRI联合功能神经导航有助于低级别胶质瘤最大限度的安全切除.
목적 평개고장강술중자공진(iMRI)대저급별효질류절제정도적영향.방법 59례저급별효질류환자접수고장강iMRI연합공능신경도항하현미수술,분별우수차화말차iMRI소묘후계산종류절제솔화절제정도.우술전、술후급수방시평고신경공능.결과 소유병례균성공실시iMRI여공능신경도항.수차iMRI발현술자대21례(35.6％)종류적전절솔발생오판.수차iMRI발현17례(28.8％)종류잔류,계속절제사8례(13.6％)득도전절.iMRI사절제정도종수차소묘후적(90±15)％제고도말차소묘후적(94±12)％(P＜0.01).재종류계속절제적17례환자중,절제정도종(78±17)％제고지(91±12)％(P＜0.01).3개월수방시2례(3.4％)유류신경공능장애.결론 iMRI연합공능신경도항유조우저급별효질류최대한도적안전절제.
Objective To evaluate the influences of high-field intraoperative magnetic resonance imaging(iMRI)on the extent of resection(EoR)in low-grade gliomas.Methods Fifty-nine patients with low-grade gliomas underwent microsurgeries under the guidance of high-field iMRI and functional neuronavigation.The rates of gross total removal and EoR were recorded after initial and final iMRI scans and neurological performances were evaluated peri-operatively and at follow-up.Results iMRI and functional neuronavigation were successfully performed in all patients.Initial iMRI found that the rates of gross total removal were misestimated in 21 cases(35.6％).In 17 cases(28.8％),initial iMRI revealed resectable residual tumors and further resection achieved gross total removal in 8 cases(13.6％).iMRI boosted the level of EoR from 90％ + 15％ to 94％ ± 12％(P ＜ 0.001)in all cases and from 78％ ± 17％ to 91％ ±12％ in 17 cases undergoing further tumor resections.At 3-month follow-up,2 cases(3.4％)developed neurological deficits.Conclusion The combination of iMRI and functional neuronavigation helped maximize safe tumor resection in low-grade gliomas.