Department of Neurological Surgery University of Miami Miller School of Medicine, Miami, Florida, USA.
Department of Neurological Surgery University of Miami Miller School of Medicine, Miami, Florida, USA.
World Neurosurg. 2021 Jun;150:e108-e116. doi: 10.1016/j.wneu.2021.02.097. Epub 2021 Feb 27.
Frozen section is a time- and labor-intensive method for intraoperative pathologic diagnosis. As a result, there exists a need to expedite and streamline the acquisition and interpretation of diagnostic histologic data to inform surgical decision making. Stimulated Raman histology (SRH) is an emerging technology that may serve to expedite the acquisition and interpretation of histologic data in the operating room.
A blinded, prospective cohort study of 82 patients undergoing resection for tumors of the central nervous system was performed. Twenty-six patients with diagnoses of meningioma on SRH, frozen, or permanent section were included in this subanalysis. Diagnostic time and accuracy of stimulated SRH histology images were compared with the gold standard (frozen section). Agreement of SRH and frozen section diagnosis with permanent section (true) diagnosis was also compared.
Mean time-to-diagnosis was significantly shorter for SRH-mediated diagnosis compared with frozen section (9.2 vs. 35.8, P < 0.0001). Diagnostic accuracy was not significantly different between methods (P = 0.15). Diagnostic agreement was not significantly different between SRH versus frozen, SRH versus permanent, or frozen versus permanent section methods (P = 0.5, P = 0.5, P = 1.00).
SRH is a promising adjuvant technology that may expedite intraoperative neuropathologic consult without sacrificing diagnostic accuracy.
冰冻切片是一种耗时耗力的术中病理诊断方法。因此，需要加快和简化获取和解释诊断组织学数据的过程，以辅助手术决策。受激拉曼组织学（SRH）是一种新兴技术，可用于加快手术室中组织学数据的获取和解释。
对 82 例因中枢神经系统肿瘤而行切除术的患者进行了一项盲法、前瞻性队列研究。对 26 例经 SRH、冰冻或石蜡切片诊断为脑膜瘤的患者进行了这项亚分析。比较了受激 SRH 组织学图像的诊断时间和准确性与金标准（冰冻切片）。还比较了 SRH 和冰冻切片诊断与永久切片（真实）诊断的一致性。
与冰冻切片相比，SRH 介导的诊断平均诊断时间明显更短（9.2 与 35.8，P<0.0001）。两种方法的诊断准确性无显著差异（P=0.15）。SRH 与冰冻切片、SRH 与石蜡切片或冰冻切片与石蜡切片之间的诊断一致性无显著差异（P=0.5、P=0.5、P=1.00）。
SRH 是一种很有前途的辅助技术，它可以在不牺牲诊断准确性的情况下加快术中神经病理咨询的速度。
