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[多模态导航联合术中磁共振成像在颅内病变无框架立体定向活检中的应用]

[Implementation of multimodal navigation combined with intraoperative magnetic resonance imaging in the frameless stereotactic biopsy of intracranial lesions].

作者信息

Zhang J S, Chen X L, Wang Q, Hou Y Z, Sun G C, Li F Y, Yu X G, Xu B N

机构信息

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

出版信息

Zhonghua Yi Xue Za Zhi. 2017 Aug 1;97(29):2288-2292. doi: 10.3760/cma.j.issn.0376-2491.2017.29.012.

DOI:10.3760/cma.j.issn.0376-2491.2017.29.012
PMID:28780845
Abstract

To investigate the impact and value of multimodal navigation and intraoperative magnetic resonance imaging (iMRI) on the biopsy of intracranial lesions. From February, 2009 to December, 2016, this study enrolled 156 patients, who underwent multimodal navigation and iMRI-guided brain biopsy in the Neurosurgery Department of PLA General Hospital. Metabolic information was used for biopsy target selection. Intraoperative guidance helped biopsy trajectory avoid the eloquent structures. iMRI was performed to prove the biopsy accuracy and to revise the incorrect biopsy. Diagnostic rate, perioperative neurological status, surgical parameter, and surgical outcome were recorded. The first iMRI helped to revise 7 (4.5%) incorrect biopsy sites, and final iMRI confirmed biopsy accuracy in all cases. Postoperative diagnostic rate was 96.8% (151/156). No statistical difference was found between postoperative and preoperative neurological statuses, despite 86 (55.1%) lesions were adjacent to eloquent areas. Additionally, iMRI detected 6 (3.8%) intraoperative hematomas that were treated immediately. Brian biopsy with iMRI and multimodal navigation is a safe, accurate and efficient biopsy modality. This technique may help increase the biopsy accuracy with low morbidity and mortality.

摘要

探讨多模态导航及术中磁共振成像(iMRI)在颅内病变活检中的影响及价值。2009年2月至2016年12月,本研究纳入156例患者,这些患者在中国人民解放军总医院神经外科接受了多模态导航及iMRI引导下的脑活检。利用代谢信息进行活检靶点选择。术中引导有助于活检路径避开功能区结构。进行iMRI以证实活检准确性并修正错误活检。记录诊断率、围手术期神经状态、手术参数及手术结果。首次iMRI有助于修正7例(4.5%)错误活检部位,最终iMRI在所有病例中均证实了活检准确性。术后诊断率为96.8%(151/156)。尽管86例(55.1%)病变毗邻功能区,但术后与术前神经状态之间未发现统计学差异。此外,iMRI检测到6例(3.8%)术中血肿并立即进行了处理。采用iMRI及多模态导航进行脑活检是一种安全、准确且高效的活检方式。该技术可能有助于提高活检准确性,降低发病率和死亡率。

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