Ferroli P, Acerbi F, Albanese E, Tringali G, Broggi M, Franzini A, Broggi G
Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milano, Italy.
Acta Neurochir Suppl. 2011;109:251-7. doi: 10.1007/978-3-211-99651-5_40.
To investigate the application of indocyanine green (ICG) videoangiography during microsurgery for central nervous system (CNS) tumors.
One hundred patients with CNS tumors who underwent microsurgical resection from December 2006 to December 2008 were retrospectively analyzed. The diagnosis was high grade glioma in 54 cases, low grade in 17 cases, meningioma in 14 cases, metastasis in 12 cases and hemangioblastoma in 3 cases. Overall, ICG was injected intraoperatively 194 times. The standard dose of 25mg of dye was injected intravenously and intravascular fluorescence from within the blood vessels was imaged through an ad hoc microscope with dedicated software (Pentero, Carl Zeiss Co., Oberkochen, Germany). Pre-resection and post-resection arterial, capillary and venous ICG videoangiographic phases were intraoperatively observed and recorded.
ICG videangiography allowed for a good evaluation of blood flow in the tumoral and peritumoral exposed vessels in all cases. No side effects due to ICG were observed.
ICG video-angiography is a significant method for monitoring blood flow in the exposed vessels during microsurgical removal of CNS tumors. Pre-resection videoangiography provides useful information on the tumoral circulation and the pathology-induced alteration in surrounding brain circulation. Post-resection examination allows for an immediate check of patency of those vessels that are closely related to the tumor mass and that the surgeon does not want to damage.
探讨吲哚菁绿（ICG）血管造影术在中枢神经系统（CNS）肿瘤显微手术中的应用。
回顾性分析2006年12月至2008年12月期间接受显微手术切除的100例CNS肿瘤患者。诊断为高级别胶质瘤54例，低级别胶质瘤17例，脑膜瘤14例，转移瘤12例，血管母细胞瘤3例。总体而言，术中注射ICG共194次。静脉注射25mg标准剂量的染料，通过配有专用软件的特制显微镜（德国奥伯科亨卡尔蔡司公司的Pentero）对血管内的血管内荧光进行成像。术中观察并记录切除前和切除后动脉、毛细血管和静脉ICG血管造影阶段。
ICG血管造影术在所有病例中均能很好地评估肿瘤及肿瘤周围暴露血管的血流情况。未观察到因ICG引起的副作用。
ICG血管造影术是在显微手术切除CNS肿瘤过程中监测暴露血管血流的重要方法。切除前血管造影术可提供有关肿瘤循环以及病理引起的周围脑循环改变的有用信息。切除后检查可立即检查与肿瘤块密切相关且外科医生不想损伤的那些血管的通畅情况。
