Torcuator Roy G, Hulou M Maher, Chavakula Vamsidhar, Jolesz Ferenc A, Golby Alexandra J
Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
J Clin Neurosci. 2016 Feb;24:68-73. doi: 10.1016/j.jocn.2015.09.008. Epub 2015 Nov 16.
Stereotactic radiosurgery is one of the treatment options for brain metastases. However, there are patients who will progress after radiosurgery. One of the potential treatments for this subset of patients is laser ablation. Image-guided stereotactic biopsy is important to determine the histopathological nature of the lesion. However, this is usually based on preoperative, static images, which may affect the target accuracy during the actual procedure as a result of brain shift. We therefore performed real-time intraoperative MRI-guided stereotactic aspiration and biopsies on two patients with symptomatic, progressive lesions after radiosurgery followed immediately by laser ablation. The patients tolerated the procedure well with no new neurologic deficits. Intraoperative MRI-guided stereotactic biopsy followed by laser ablation is safe and accurate, providing real-time updates and feedback during the procedure.
立体定向放射外科是脑转移瘤的治疗选择之一。然而，有些患者在接受放射外科治疗后病情仍会进展。对于这部分患者，一种潜在的治疗方法是激光消融。图像引导立体定向活检对于确定病变的组织病理学性质很重要。然而，这通常基于术前的静态图像，由于脑移位，在实际操作过程中可能会影响靶点的准确性。因此，我们对两名在放射外科治疗后出现有症状的进展性病变的患者进行了实时术中磁共振成像引导下的立体定向抽吸和活检，随后立即进行激光消融。患者对该手术耐受性良好，未出现新的神经功能缺损。术中磁共振成像引导下的立体定向活检继以激光消融是安全且准确的，在手术过程中可提供实时更新和反馈。
