CAJ | 학술논문

目的探讨高场强术中核磁共振(iMRI)引导的立体定向手术在颅内多发病变诊断和治疗中的应用价值和优势.方法回顾性分析2011年6月至2013年5月,天津医科大学总医院神经外科收治的18例颅内多发病变患者,均在高场强iMRI引导下实施有框架立体定向诊治手术;其中立体定向活体组织检查6例,脑脓肿穿刺引流术4例,以囊性为主的颅咽管瘤穿刺抽吸加32p内放疗3例,立体定向多发血肿穿刺抽吸术5例.结果 6例行立体定向活体组织检查者精确获取预定的靶点标本,iMRI验证所取病理标本准确;病理学诊断符合临床随访结果;12例多发囊性病变及多发颅内血肿者,液体和血肿抽吸满意,明显缩短临床治疗时间,术中及术后无严重并发症.结论 iMRI引导立体定向手术靶点定位精确,对明确颅内多发病变的病理诊断及缩短临床治疗时间有重要意义.
목적 탐토고장강술중핵자공진(iMRI)인도적입체정향수술재로내다발병변진단화치료중적응용개치화우세.방법 회고성분석2011년6월지2013년5월,천진의과대학총의원신경외과수치적18례로내다발병변환자,균재고장강iMRI인도하실시유광가입체정향진치수술;기중입체정향활체조직검사6례,뇌농종천자인류술4례,이낭성위주적로인관류천자추흡가32p내방료3례,입체정향다발혈종천자추흡술5례.결과 6례행입체정향활체조직검사자정학획취예정적파점표본,iMRI험증소취병리표본준학;병이학진단부합림상수방결과;12례다발낭성병변급다발로내혈종자,액체화혈종추흡만의,명현축단림상치료시간,술중급술후무엄중병발증.결론 iMRI인도입체정향수술파점정위정학,대명학로내다발병변적병리진단급축단림상치료시간유중요의의.
Objective To explore the diagnostic and therapeutic values of stereotactic guidance of intraoperative high-field magnetic resonance imaging (iMRI) for multiple intracranial lesions.Methods We retrospectively assessed 18 patients with multiple intracranial lesions undergoing stereotactic guidance of high-field iMRI between June 2011 and May 2013.The procedures included biopsy of stereotactic guidance (n =6),stereotactic aspiration and drainage for brain abscess (n =4),stereotactic aspiration and intracavitary irradiation with 32p for mixed solid and cystic craniopharyngiomas (n =3) and stereotactic hematoma evacuation (n =5).Results For 6 cases with high-field iMRI stereotactic guidance,the target lesions were precisely predetermined and pathological specimens confirmed by clinical follow-up results.For 12 cases with multiple cystic lesions and multiple intracranial hematoma,aspiration of hematoma and liquids was satisfactory.And the course of clinical treatment was significantly shortened.And there was a lower incidence of postoperative complications.Conclusion iMRI may guide precisely stereotactic surgery.And it has important clinical significance for confirming the diagnosis of multiple intracranial lesions and shortening their treatment courses.