The Brain and Mind Research Institute, The University of Sydney, 94 Mallet Street, Camperdown, NSW, Australia.
Neurosurg Rev. 2013 Apr;36(2):205-14; discussion 214. doi: 10.1007/s10143-012-0436-8. Epub 2012 Nov 29.
Historically, brain tumour resection has relied upon standardised anatomical atlases and classical mapping techniques for successful resection. While these have provided adequate results in the past, the emergence of new technologies has heralded a wave of less invasive, patient-specific techniques for the mapping of brain function. Functional magnetic resonance imaging (fMRI) and, more recently, diffusion tensor imaging (DTI) are two such techniques. While fMRI is able to highlight localisation of function within the cortex, DTI represents the only technique able to elucidate white matter structures in vivo. Used in conjunction, both of these techniques provide important presurgical information for thorough preoperative planning, as well as intraoperatively via integration into frameless stereotactic neuronavigational systems. Together, these techniques show great promise for improved neurosurgical outcomes. While further research is required for more widespread clinical validity and acceptance, results from the literature provide a clear road map for future research and development to cement these techniques into the clinical setup of neurosurgical departments globally.
从历史上看,脑肿瘤切除术依赖于标准化的解剖图谱和经典的映射技术来实现成功切除。虽然这些在过去提供了足够的结果,但新技术的出现预示着针对脑功能映射的侵袭性更小、更具个体针对性的技术的浪潮。功能磁共振成像 (fMRI) 以及最近的扩散张量成像 (DTI) 就是两种这样的技术。虽然 fMRI 能够突出皮层内的功能定位,但 DTI 是唯一能够在体内阐明白质结构的技术。这两种技术结合使用,可以为彻底的术前规划提供重要的术前信息,并且可以通过集成到无框架立体定向神经导航系统中来实现术中使用。这些技术都有很大的潜力来改善神经外科的结果。虽然需要进一步的研究来提高更广泛的临床有效性和接受度,但文献中的结果为未来的研究和开发提供了明确的路线图,以将这些技术牢固地融入全球神经外科部门的临床设置中。