术中磁共振影像神经导航手术的临床初步应用

目的:探讨术中核磁共振影像神经导航(intraoperative MR image-based neuronavigation)技术在神经外科手术的意义。方法:应用PoleStarN-20术中磁共振成像(iMRI)神经导航系统施行神经外科手术22例。对其临床资料、iMRI情况,及其对手术进程和手术结果的影响进行分析。结果:22例手术中,经鼻-蝶垂体瘤切除术10例,幕上开颅肿瘤切除术10例,幕下开颅肿瘤切除术2例。iMRI扫描次数从2～5次不等,平均2.6次。共有9例术中扫描发现有肿瘤残留,其中8例(36.4%),需做进一步的切除,最终肿瘤的全切率从60%提高到86.4%。无与iMRI相关的并发症。结论:iMRI神经导航技术的应用,为神经外科手术入路的选择、皮肤切口的设计、手术进程的指导及手术结果的实时判断提供了客观的依据,从而在提高手术的精确性和安全性的同时,提高了颅脑肿瘤的全切率。

Intraoperative MR Image-based Neuronavigation Surgery: Preliminary Experience in 22 Patients

Aim:To evaluate the benefits of intraoperative MR image-based neuronavigation in surgical procedures. Methods:22 surgeries were performed using the PoleStar N-20 intraoperative MRI (iMRI) neuronavigation system. The clinical materials, image acquisition and its influence on the surgical planning, surgical process and surgical consequences were analyzed. Results: These cases included 10 transsphenoidal pituitary adenoma resections, 12 craniotomies (10 supratentorial tumor resections and 2 infratentorial tumor resections). The number of scans ranged from two to five per surgery (average 2.6). In 9 cases intraoperative imaging revealed residual tumor , 8 of them needed further resection. With the guidance of intraoperative MR, the percentage of gross total removal increased from 60% to 86.4%. There was no iMR-related complication. Conclusion:With providing objective informations for the guidance of surgical procedure and the real-time judgement of surgical consequence, the intraoperative MR image-based neuronavigation can improve the accuracy and safety of neurosurgical procedures.