Department of Neurosurgery, Neuro-Oncology Clinic and Brain Research Institute, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemoon-gu, Seoul 120-752, Korea.
Acta Neurochir (Wien). 2011 Jul;153(7):1487-95; discussion 1494-5. doi: 10.1007/s00701-011-1046-x. Epub 2011 May 19.
Videoangiography using indocyanine green (ICG) has been used in the ophthalmologic field for a long time. It was introduced to the neurosurgical field several years ago but has been limited to vascular surgeries. We applied ICG videoangiography to brain tumor surgery and evaluated the usefulness.
Twenty-three patients with a brain tumor who underwent microsurgical resection were analyzed. The pathological diagnosis was meningioma in 15 patients, metastasis in three, glioma in three, and hemangioblastoma in two. A microscope with a special filter and infrared excitation light to illuminate the operating field was used in this study. The intravascular fluorescence was imaged with a video camera attached to the microscope. ICG was injected intravenously with the dose of 5-25 mg, and overall, ICG was injected intraoperatively 32 times.
ICG videoangiography allowed for an excellent evaluation of blood flow in the tumoral and peri-tumoral vessels both before and after the resection in all cases.
ICG videoangiography is a useful method for monitoring blood flow in the exposed vessels during microsurgery for a brain tumor. This noninvasive method is simple, safe, cost-effective, and easily repeatable. Before resection, it provides information on the tumoral and peri-tumoral circulation including sequential visualization of vessels or direction of the blood flow. After resection, it checks the patency of the peri-tumoral vessels and is especially useful for the vein. This ICG videoangiography can be an alternative tool to intraoperative angiography or Doppler ultrasonography in selective cases.
吲哚菁绿（ICG）视频血管造影术在眼科领域已经使用了很长时间。几年前它被引入神经外科领域，但仅限于血管手术。我们将 ICG 视频血管造影术应用于脑肿瘤手术，并评估了其有用性。
分析了 23 例接受显微切除术的脑肿瘤患者。病理诊断为脑膜瘤 15 例，转移瘤 3 例，胶质瘤 3 例，血管母细胞瘤 2 例。本研究使用带有特殊滤光片和红外激发光的显微镜照射手术区域。将附接到显微镜上的摄像机拍摄血管内荧光图像。将 5-25mg 的 ICG 静脉内注射，总共在手术期间进行了 32 次 ICG 注射。
在所有病例中，ICG 视频血管造影术都能在肿瘤和肿瘤周围血管的切除前后进行出色的血流评估。
ICG 视频血管造影术是监测脑肿瘤显微手术中暴露血管血流的有用方法。这种非侵入性方法简单、安全、具有成本效益，并且易于重复。在切除前，它提供了关于肿瘤和肿瘤周围循环的信息，包括血管的顺序可视化或血流方向。切除后，它检查肿瘤周围血管的通畅性，对静脉特别有用。在某些情况下，这种 ICG 视频血管造影术可以替代术中血管造影或多普勒超声检查。
