术中运动功能区定位在高场强术中磁共振成像辅助胶质瘤手术中的应用
Utilization of intraoperative motor mapping in glioma surgery with high-field intraoperative magnetic resonance imaging.
作者信息
Hatiboglu Mustafa Aziz, Weinberg Jeffrey S, Suki Dima, Tummala Sudhakar, Rao Ganesh, Sawaya Raymond, Prabhu Sujit S
机构信息
Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, Tex. 77030, USA.
出版信息
Stereotact Funct Neurosurg. 2010;88(6):345-52. doi: 10.1159/000319837. Epub 2010 Aug 21.
BACKGROUND/AIMS: The main goal of glioma surgery is to maximize tumor resection while minimizing neurologic injury. The use of high-field intraoperative magnetic resonance imaging (iMRI) and intraoperative cortical mapping (IOM) together enable the surgeon to increase the extent of tumor resection (EOR) and preserve the neurological function. However, there is insufficient evidence to validate the use of IOM with high-field iMRI.
METHODS
To study the safety and utility of IOM in a high-field (1.5 T) iMRI suite, we retrospectively studied 38 patients with glioma who underwent surgery with IOM in the iMRI suite.
RESULTS
We were able to use IOM in the iMRI suite without any adverse side effects or difficulty. Median EOR was 97%. A new or worsening motor deficit occurred in 14 (37%) patients immediately after the surgery, with 3 (8%) patients exhibiting persistent deficit at 6 months.
CONCLUSION
Our findings suggest that IOM can be successfully used in a high-field MRI environment and can help minimize postoperative motor deficit with a higher EOR.
背景/目的：胶质瘤手术的主要目标是在使神经损伤最小化的同时，最大程度地切除肿瘤。术中使用高场强磁共振成像（iMRI）和术中皮层图谱（IOM），可使外科医生提高肿瘤切除范围（EOR）并保留神经功能。然而，尚无充分证据证实高场强iMRI联合使用IOM的有效性。
方法
为研究IOM在高场强（1.5T）iMRI设备中的安全性和实用性，我们回顾性研究了38例在iMRI设备中接受IOM手术的胶质瘤患者。
结果
我们能够在iMRI设备中使用IOM，且未出现任何不良副作用或困难。EOR中位数为97%。14例（37%）患者术后立即出现新的或加重的运动功能障碍，其中3例（8%）患者在6个月时仍存在持续性功能障碍。
结论
我们的研究结果表明，IOM可在高场强MRI环境中成功使用，并有助于在提高EOR的同时，使术后运动功能障碍最小化。
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