立体定向开颅术中病灶边缘点的定位

目的:通过对脑深部病灶边缘点定位,在立体定向开颅手术中引导术者,以期彻底切除病灶。方法:应用驹井式计算机体层摄影(CT)立体定向仪对11例脑深部病灶进行立体定向开颅手术,其中胶质瘤8例,转移瘤3例,直径25～45mm,影像学显示肿瘤边界不清。术前对病灶边缘点三维座标进行测量登记,术中通过导针引导切除病灶。结果:术后半月内增强CT或磁共振成像(MRI)扫描显示:9例病灶完全消失,2例肿瘤周边有少许残余。无手术死亡及昏迷等。结论:对于脑深部边缘不清的病灶,在立体定向开颅手术切除病灶时,对病灶边缘点定位,可较彻底切除病灶,减少手术病灶残留。

The localization of the peripheral points of the lesions in stereotactic craniotomy

To guide the operator during resecting a tumor by localization of the peripheral points of a deep-seated targets when the margin of the lesions was not clear. Method: Using Komai's CT-stereotactic apparatus, stereotactic craniotomy was performed on 11 patients, in whom the lesions were located deeply in the brain, including 8 cases of glioma and 3 cases of metastasis. The diameters ranged from 25 to 45 mm. The margin of the tumors was not defined on MRI or CT scanning. The three-dimentional coordinates of the periphery parts of lesions were measured and registered before operation. Those lesions were resected along their periphery margin by the guided-probe during operation. Result: The CT or MRI scanning taken in half a month after operation showed that the lesions disappeared totally in 9 cases and a little residual at the periphery of tumors in 2 cases. No mortality occured. Conclusion: With the aid of localization of the periphery margin of deep-seated lesions can help to resect the tumor totally and to get rid of residues of the tumors during the stereotactic cranioto- mv.