神经导航系统在颅内病变手术治疗中的应用
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摘要
目的探讨神经导航系统在颅内病变显微手术中的应用效果。方法回顾性分析2017年6月至2018年8月在神经导航系统辅助下手术切除的72例颅内病变的临床资料。结果 72例均在导航下顺利完成手术,病灶定位准确率为100%。术后复查MRI发现,病灶全切除63例,次全切除8例,大部分切除1例。术后症状显著好转或改善54例,无明显变化16例,加重2例。术后均没有严重的并发症,无新发神经功能障碍,无死亡病例。72例术后随访3～12个月;复查MRI未见复发。结论神经导航系统有助于精确定位颅内病灶,提高全切率,是显微手术切除颅内病变的有效辅助手段。
Objective To explore the therapeutic effect of neuronavigator-assisted neurosurgery on intracranial lesions. Method The clinical data of 72 patients with intracranial lesions, who were treated by neuronavigator-assisted neurosurgery in our department from June, 2017 to August, 2018, were analyzed retrospectively. Results The neuronavigator-assisted neurosurgery were successfully completed in all the patients, in whom all the intracranial lesions were accurately located. Of 72 patients, 63 received total resection of the lesions, 8 subtotal and 1 greatly partial. No patients died from the operation. The postoperative clinical symptoms were improved in 54 patients, unchanged in 16 and aggravated in 2. No lesions recurred in all the patients during the fallowing up for 3～12 months.Conclusions The neuronavigator is helpful to accurate location of the intracranial lesions and increase in their total resection rate. The neuronavigator-assisted neurosurgery is an effective method to resect the intracranial lesions and it is worthy of wide clinical application and spread.
Objective To explore the therapeutic effect of neuronavigator-assisted neurosurgery on intracranial lesions. Method The clinical data of 72 patients with intracranial lesions, who were treated by neuronavigator-assisted neurosurgery in our department from June, 2017 to August, 2018, were analyzed retrospectively. Results The neuronavigator-assisted neurosurgery were successfully completed in all the patients, in whom all the intracranial lesions were accurately located. Of 72 patients, 63 received total resection of the lesions, 8 subtotal and 1 greatly partial. No patients died from the operation. The postoperative clinical symptoms were improved in 54 patients, unchanged in 16 and aggravated in 2. No lesions recurred in all the patients during the fallowing up for 3～12 months.Conclusions The neuronavigator is helpful to accurate location of the intracranial lesions and increase in their total resection rate. The neuronavigator-assisted neurosurgery is an effective method to resect the intracranial lesions and it is worthy of wide clinical application and spread.
引文
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[2]王世龙,刘祺,赵冬,等. DTI导航下颅内病变的显微手术[J].中国临床神经外科杂志,2016,21(7):401-403.
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[6]姜晓峰,牛朝诗,傅先明,等.术中实时超声导航在脑深部肿瘤切除术中的应用[J].中华神经医学杂志,2010,9(9):922-926.
[7]古军,王本瀚,姚安会,等.神经导航引导下脑干背侧肿瘤的手术治疗[J].中国临床神经外科杂志,2018,23(1):35-37.
[8]Berntsen EM, Gulati S, Solheim O, et al. Functional magnetic resonance imaging and diffusion tensor tractography incorporated into an intraoperative 3-dimensional ultrasound based neuronavigation system:impact on therapeutic strategies, extent of resection, and clinical outcome[J].Neurosurgery, 2010, 67(2):251-264.
[2]王世龙,刘祺,赵冬,等. DTI导航下颅内病变的显微手术[J].中国临床神经外科杂志,2016,21(7):401-403.
[3]Fraioli MF, Moschettoni L, Fraioli C, et al. Utility of neuronavigator in transsphenoidal reoperations[J]. Neurosurg Q,2010, 20(1):5-7.
[4]Dolati P, Eichberg D, Golby A, et al. Multimodal navigation in endoscopic transsphenoidal resection of pituitary tumors using image-based vascular and cranial nerve segmentation:a prospective validation study[J]. World Neurosurg,2016, 95:406-413.
[5]Gerard IJ, Kersten-Oertel M, Petrecca K, et al. Brain shift in neuronavigation of brain tumors:a review[J]. Med Image Anal, 2017, 35:403-420.
[6]姜晓峰,牛朝诗,傅先明,等.术中实时超声导航在脑深部肿瘤切除术中的应用[J].中华神经医学杂志,2010,9(9):922-926.
[7]古军,王本瀚,姚安会,等.神经导航引导下脑干背侧肿瘤的手术治疗[J].中国临床神经外科杂志,2018,23(1):35-37.
[8]Berntsen EM, Gulati S, Solheim O, et al. Functional magnetic resonance imaging and diffusion tensor tractography incorporated into an intraoperative 3-dimensional ultrasound based neuronavigation system:impact on therapeutic strategies, extent of resection, and clinical outcome[J].Neurosurgery, 2010, 67(2):251-264.