CAJ | 학술논문

目的探讨高场强术中磁共振(iMRI)神经导航系统对经鼻蝶窦入路垂体腺瘤切除手术的辅助作用.方法回顾性分析天津医科大学总医院神经外科2011年4月至2014年4月应用高场强iMRI神经导航系统辅助经鼻蝶窦入路手术切除335例垂体腺瘤,总结其手术效果和应用经验.结果 185例患者在iMRI检查中共发现58例存在肿瘤残余,其中40例患者在更新神经导航计划后进一步行手术全切除肿瘤.初次全切除率为68.7％ (127/185),在iMRI导航系统辅助下最终全切除率达90.3％ (167/185),提高了21.6％ (40/185).高场强iMRI扫描1～3次,所需时间15 ～20 min/次;手术时间共延长了30～60min,平均(41.30 ±5.62) min.结论经鼻蝶窦入路垂体肿瘤切除术中应用高场强iMRI结合神经导航技术,为指导手术进程及实时判断手术效果提供了客观依据,提高了手术安全性和肿瘤全切除率.
목적 탐토고장강술중자공진(iMRI)신경도항계통대경비접두입로수체선류절제수술적보조작용.방법 회고성분석천진의과대학총의원신경외과2011년4월지2014년4월응용고장강iMRI신경도항계통보조경비접두입로수술절제335례수체선류,총결기수술효과화응용경험.결과 185례환자재iMRI검사중공발현58례존재종류잔여,기중40례환자재경신신경도항계화후진일보행수술전절제종류.초차전절제솔위68.7％ (127/185),재iMRI도항계통보조하최종전절제솔체90.3％ (167/185),제고료21.6％ (40/185).고장강iMRI소묘1～3차,소수시간15 ～20 min/차;수술시간공연장료30～60min,평균(41.30 ±5.62) min.결론 경비접두입로수체종류절제술중응용고장강iMRI결합신경도항기술,위지도수술진정급실시판단수술효과제공료객관의거,제고료수술안전성화종류전절제솔.
Objective To investigate the assistant effects of high-field intraoperative magnetic resonance imaging (iMRI)-based neuronavigation system in transnasal-sphenoidal approach for resection of pituitary adenomas.Methods The pituitary adenomas of 335 patients resected via high-field iMRI-based neuronavigation system assisted transnasal-sphenoidal approach at the Department of Neurosurgery,Tianjin Medical University General Hospital from April 2011 to April 2014 were analyzed retrospectively.The operative effect and application experiences were analyzed.Results Of the 185 patients,58 had residual tumor tissue in the iMRI detection,40 of them underwent further surgical resection of tumor after updating neuronavigation plan.The initial total resection rate was 68.7％ (127/185).Under the assistance of iMRI navigation system,the final total resection rate reached 90.3％ (167/185),increasing by 21.6％ (40/185).High-field iMRI scan was performed for 1 to 3 times.The time required was 15-20 min/time.The total operative time prolonged 30 to 60 min (mean,41.30 ± 5.62 min).Conclusions In transnasal-sphenoidal approach for resection of pituitary adenomas,using high-field iMRI in combination with neuronavigation technology may provide objective evidence for the guidance of surgical process and real-time judgment of surgical results,and improve the surgical safety and total resection rate of tumors.