DTI导航下颅内病变的显微手术

目的 探讨磁共振弥散张量成像（DTI）神经导航在颅内病变手术中的应用价值。方法 2015年1月至2015年12月DTI导航下切除颅内病变30例。结果 所有病变均准确定位，手术顺利，注册误差（2.11±0.37）mm，手术时间（222±60）min，术中出血（207±133）ml，均未输血。1例活检准确定位，术后未出现功能障碍；3例动脉瘤均准确夹闭，术后无神经功能障碍。其余26例28个病灶中，显微镜下全切26个，次全切2个，全切率为92.9%；术后复查CT或MRI示全切25个，次全切3个，全切率为89.3%。术后出现一过性功能障碍2例，出院时恢复正常；运动功能障碍及面神经受损各1例。结论 DTI导航系统安全、易于操作、容易掌握，有助于准确定位颅内病变，提高手术安全性，减少并发症。

Application of DTI optic navigation to diagnosis and surgical treatment of intracranial lesions

Objective To explore the value of diffusion tensor imaging (DTI) optic navigation to the diagnosis and surgical treatment of intracranial lesions. Methods The clinical data of 30 patients with 32 intracranial lesions, who received DTI optic navigation in the diagnosis and surgical treatment of the intracranial lesion from January, 2015 to December, 2015, were analyzed retrospectively. Results All the intracranial lesions were exactly located. The error of intraoperative navigation was (2.11±0.37)mm. The operating time was (222±60) min. The intraoperative bleeding volume was (207±133)ml. The lesions were totally removed in 25 patients and subtotally in 3. The intracranial aneurysms were successfully clipped in 3 patients. The definite diagnosis was made by the biopsy after the puncture in 1 patient. Of 27 patients with preoperative neurological dysfunction, 25 were recovered well and 2 unchanged after the surgery. Three patients without preoperative neurological dysfunction were recovered well. Conclusions DTI optic navigation which is a safe and easily handled technique is helpful to the diagnosis and surgical treatment of the intracranial lesions because it can exactly locate the lesions and lessen the postoperative complication.