[高场强术中磁共振成像对低级别胶质瘤切除范围的影响]

[Influences of high-field intraoperative magnetic resonance imaging on the extent of resection in low-grade gliomas].

作者信息

Zhang Jia-shu, Chen Xiao-lei, Li Fang-ye, Li Jin-jiang, Zheng Gang, Zhang Ting, Hu Shen, Xu Bai-nan

机构信息

Department of Neurosurgery, PLA General Hospital, Beijing 100853, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2012 Jul 3;92(25):1738-41.

PMID:22944179

Abstract

OBJECTIVE

To evaluate the influences of high-field intraoperative magnetic resonance imaging (iMRI) on the extent of resection (EoR) in low-grade gliomas.

METHODS

Fifty-nine patients with low-grade gliomas underwent microsurgeries under the guidance of high-field iMRI and functional neuro-navigation. The rates of gross total removal and EoR were recorded after initial and final iMRI scans and neurological performances were evaluated peri-operatively and at follow-up.

RESULTS

iMRI and functional neuronavigation were successfully performed in all patients. Initial iMRI found that the rates of gross total removal were misestimated in 21 cases (35.6%). In 17 cases (28.8%), initial iMRI revealed resectable residual tumors and further resection achieved gross total removal in 8 cases (13.6%). iMRI boosted the level of EoR from 90% ± 15% to 94% ± 12% (P < 0.001) in all cases and from 78% ± 17% to 91% ± 12% in 17 cases undergoing further tumor resections. At 3-month follow-up, 2 cases (3.4%) developed neurological deficits.

CONCLUSION

The combination of iMRI and functional neuronavigation helped maximize safe tumor resection in low-grade gliomas.

摘要

目的

评估高场术中磁共振成像（iMRI）对低级别胶质瘤切除范围（EoR）的影响。

方法

59例低级别胶质瘤患者在高场iMRI和功能神经导航引导下接受显微手术。在初次和最终iMRI扫描后记录全切率和EoR，并在围手术期和随访时评估神经功能表现。

结果

所有患者均成功进行了iMRI和功能神经导航。初次iMRI发现21例（35.6%）患者的全切率被误估。17例（28.8%）患者初次iMRI显示有可切除的残留肿瘤，进一步切除后8例（13.6%）实现了全切。iMRI使所有病例的EoR水平从90%±15%提高到94%±12%（P<0.001），在17例接受进一步肿瘤切除的病例中从78%±17%提高到91%±12%。在3个月的随访中，2例（3.4%）出现神经功能缺损。