全脑3D-MRI在神经导航术中的应用

目的:探讨全脑3D-MRI在神经导航手术中的应用价值。方法:回顾分析30例脑肿瘤患者,根据不同的类型选择相应的MRI序列进行全脑3D-T2WI或3D-T1WI扫描,定位线上缘超出头顶,下缘包括鼻尖,然后图像在导航系统工作站进行三维重建,建立起脑部立体图像,导航定位并指导手术操作。结果:本组30例患者图像均采集成功,MRI原始图像与导航系统计算机融合后,三维立体重建效果满意,所有病例病灶均达到术前计划的实施全切(16例)或部分切除(14例),术后临床症状均有不同程度的改善,与以往类似患者的手术时间相比,呈缩短趋势。结论:全脑3D-MRI为神经外科术中导航提供了原始的影像资料,对于手术精确定位及路径选择具有重要的意义。

Exploring the clinical utility of neuron-navigation with 3D-MR image for neurosurgery

Objective:To assess the clinical utility of neuro-navigation with 3D-MRI image for neurosurgery.Methods:A retrospective study was conducted on patients with brain tumors treated between November 2010 and October 2011 with neuron-navigation.Standardised preoperative structural neuroimaging was performed on 30 consecutive patients.The scan sequences consisted of whole brain 3D-T2WI or 3D-T1WI scans.All the raw data of original image from top of skull to nose were acquired in supine position.And then the procedures were planned and assisted by neuro-navigation techniques with image fusion of MRI.Neuro-navigation systems allowed an exact transfer of the individual patients image data onto the operative field.It thus provided intraoperative orientation to the surgeons helping them define tumour margins or the surrounding neurovascular structures.Results:The neuroimagings were acquired successfully in all cases.Using an image-fusion technique,the integrated navigation system could combine MR imaging data together and creat three-dimensional stereoscopic image definitely.All the surgical procedures were performed under the neuro-navigational guidance in accordance with preoperative design,consisting of total resection in 16 of 30 cases and partial resection in 14 of 30 cases.Conclusion:The image-guided neuro-navigation with 3D MR image could not only provide original information focusing on brain tumor and its surroundings,but also facilitate precise localization,and be beneficial to total or subtotal or partial resection of intracranial tumours as well.Under this stereotactic guidance,surgical traumas and complications would relieve significantly in comparison with conventional neurosurgery during the surgical approach.It might be beneficial to neurosurgery and beyond in future.