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优化胶质瘤切除效果:神经外科术中磁共振成像引导的系统评价

Optimizing Glioma Resection Outcomes: A Systematic Review of Intraoperative Magnetic Resonance Imaging Guidance in Neurosurgery.

作者信息

Ali Thowaiba E, Rodoshi Zarin Nudar, Salcedo Yoalkris E, Patel Vaishvik K, Khan Ismail

机构信息

Medicine and Surgery, University of Khartoum, Khartoum, SDN.

Healthcare Administration, University of Tennessee at Chattanooga, Chattanooga, USA.

出版信息

Cureus. 2024 Jul 16;16(7):e64697. doi: 10.7759/cureus.64697. eCollection 2024 Jul.

Abstract

This systematic review evaluates the efficacy of intraoperative magnetic resonance imaging (iMRI) in enhancing glioma resection outcomes within neurosurgical procedures. Given the complexity and variability of gliomas, achieving precise and safe resections is challenging, necessitating the use of advanced imaging techniques like iMRI. This technology provides real-time, high-resolution insights during surgery, allowing for adaptations based on surgical dynamics and brain shifts. Our comprehensive search across multiple databases selected five significant studies that collectively demonstrate the beneficial impact of iMRI. These studies highlight its role in significantly improving the extent of tumor resection and suggest potential enhancements in both immediate and long-term patient outcomes. The findings indicate that iMRI facilitates more aggressive yet safe resections, particularly in high-risk glioma cases. However, the implementation of iMRI in clinical practice requires careful consideration of training, resource allocation, and the potential variability in outcomes due to study design heterogeneity. Future research should focus on randomized controlled trials to better understand the cost-effectiveness and long-term benefits of iMRI, promoting its wider adoption in neurosurgical settings.

摘要

本系统评价评估了术中磁共振成像(iMRI)在神经外科手术中提高胶质瘤切除效果方面的疗效。鉴于胶质瘤的复杂性和变异性,实现精确且安全的切除具有挑战性,因此需要使用iMRI等先进成像技术。该技术在手术过程中提供实时、高分辨率的影像,使手术能够根据手术动态和脑移位情况进行调整。我们对多个数据库进行的全面检索筛选出了五项重要研究,这些研究共同证明了iMRI的有益影响。这些研究突出了其在显著提高肿瘤切除范围方面的作用,并表明在患者近期和长期预后方面可能会有所改善。研究结果表明,iMRI有助于进行更积极但安全的切除,尤其是在高危胶质瘤病例中。然而,在临床实践中实施iMRI需要仔细考虑培训、资源分配以及由于研究设计异质性导致的结果潜在变异性。未来的研究应侧重于随机对照试验,以更好地了解iMRI的成本效益和长期益处,促进其在神经外科手术中的更广泛应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb5/11327550/d43815c82642/cureus-0016-00000064697-i01.jpg

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