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运用术前多模态影像融合技术的复杂颅底肿瘤手术治疗

Surgical Management of Complex Skull Base Tumor Using Preoperative Multimodal Image Fusion Technology.

作者信息

Jian Zhi-Heng, Chen Peng, Li Yu, Liao Chang-Chun, Yi Xin-Feng, Zhan Run-Gen, Chen Gang

机构信息

Department of Neurosurgery, Zhuhai's People Hospital, Zhuhai, China.

Department of Radiology, Zhuhai's People Hospital, Zhuhai, China.

出版信息

J Craniofac Surg. 2024 Mar 27;35(3):853-9. doi: 10.1097/SCS.0000000000010073.

Abstract

OBJECTIVE

To review our single-institution experience in the surgical management of complex skull base tumors using multimodal image fusion technology.

METHODS

From October 2019 to January 2022, 7 cases of complex skull base tumors that performed preoperative multimodal image fusion in Zhuhai People's Hospital neurosurgery department were involved in this study. The image data were uploaded to the GE AW workstation. Corresponding image sequences were opened in the workstation to complete registration fusion and 3D reconstruction. We retrospectively reviewed the clinical and imaging data, and surgical strategy, respectively.

RESULTS

one case of recurrent C2 schwannoma, 1 case of recurrent spindle cell tumor of the left cranio-orbital communication, 1 case of lobular malignant tumor of the left infratemporal fossa, 1 case of central giant cell repairing granuloma, 1 case of mesenchymal malignant tumor in left pharyngeal process, 1 case of meningioma in jugular foramen, and 1 case of hemangioblastoma with vascular malformation in fourth ventricular. All cases underwent preoperative multimodal image fusion for the surgical plan and all cases had gross total resection. Except for one case of mesenchymal malignant tumor in left pharyngeal process that had dysphagia and one case of hemangioblastoma that had discoordination, others cases were without postoperative complication.

CONCLUSIONS

Preoperative multimodal image fusion and surgical approach simulation benefit complex skull base tumor surgical treatment. Individually multiple image assessment of complex skull base tumors to determine the specific surgical strategy is more rational and should be recommended (Supplemental Digital Content 1, Supplementary Video, http://links.lww.com/SCS/F936).

摘要

目的

回顾我们单机构使用多模态图像融合技术手术治疗复杂颅底肿瘤的经验。

方法

2019年10月至2022年1月,本研究纳入珠海市人民医院神经外科7例术前行多模态图像融合的复杂颅底肿瘤患者。图像数据上传至GE AW工作站。在工作站中打开相应图像序列以完成配准融合及三维重建。我们分别回顾性分析了临床及影像资料和手术策略。

结果

包括1例复发性C2神经鞘瘤、1例左侧颅眶沟通性复发性梭形细胞瘤、1例左侧颞下窝小叶状恶性肿瘤、1例中央巨细胞修复性肉芽肿、1例左侧咽突间叶性恶性肿瘤、1例颈静脉孔脑膜瘤、1例第四脑室伴血管畸形的血管母细胞瘤。所有病例均术前行多模态图像融合以制定手术方案,且均实现了肿瘤全切。除1例左侧咽突间叶性恶性肿瘤术后出现吞咽困难、1例血管母细胞瘤术后出现共济失调外,其余病例均无术后并发症。

结论

术前行多模态图像融合及手术入路模拟有助于复杂颅底肿瘤的手术治疗。对复杂颅底肿瘤进行个体化的多图像评估以确定具体手术策略更为合理,值得推荐(补充数字内容1,补充视频,http://links.lww.com/SCS/F936)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77d5/11045550/9e101ee2e206/scs-35-0853-g001.jpg

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