术中超声联合神经导航辅助显微手术切除颅内肿瘤的临床研究

目的探讨术中超声联合神经导航在颅内肿瘤切除手术中的作用和价值。方法选择16例颅内肿瘤患者,利用MRI介导的神经导航系统引导开颅,采取合适的皮层入路,应用显微神经外科技术切除颅内肿瘤,利用术中超声判断病变切除的程度和范围,随访患者术后情况。结果所有病灶均在神经导航引导下开颅,神经导航术前对病变定位准确率为100%,骨窗暴露满意;术中超声能纠正术前神经导航定位的漂移;在其引导下14例获得全切除,2例获得次全切除;术后1例有对侧肢体肌力下降,1例轻度运动性失语,无颅内感染及死亡病例。结论术中超声联合神经导航辅助显微神经外科手术能提高颅内肿瘤定位的准确性,减少手术副损伤,提高肿瘤全切率,是一种安全有效的方法 。

Intraoperative ultrasound- and neuronavigator-assisted microsurgery for intracranial tumors

Objective To evaluate the value of application of intraoperative ultrasound combined with neuronavigation to microsurgery for the intracranial tumor.Methods The neuronavigator-assisted microsurgery through cortical approach was performed in 16 patients with intracranial tumors.The location,border,and resection extent of the tumors were determined by the neuronavigation combined with intraoperative ultrasound.Results The fiducial error was（2.3 ± 0.5）mm.The cerebral tissues shift during the neuronavigator-assisted microsurgery was corrected by the intraoperative ultrasound.Of 16 patients with intracranial tumors,14 received total removal of the tumors and 2 subtotal.The muscle strength slightly decreased in 1 patient and there was the mild motor aphasia in 1 patient after the operation.No intracranial infection and no death occurred in all the patients.Conclusions The intraoperative ultrasound-and neuronavigator-assisted microsurgery is a safe and effective method to treat the intrcranial tumors because the intraoperative ultrasound and neuronavigation is helpful to enhancement of the accuracy of location and total resection rate of the tumors,and the decrease in the side injury produced by the operation in the patients with intrcranial tumors.