解放军医学杂志2011，Vol.36Issue(7)：697-700,4.
高场强术中磁共振结合语言功能神经导航技术在胶质瘤手术中的应用
The use of high-field intra-operative magnetic resonance imaging combined with language functional neuronavigation in glioma surgery
摘要
Abstract
Objective To explore the effect of high-field intra-operative magnetic resonance imaging (iMRI) combined with language functional neuronavigation in resection of glioma in language area of dominant hemisphere of the brain. Methods Twenty right handed patients (12 males and 8 females, aged from 20 to 61 years with mean of 43. 6 years) with glioma close to arcuate fasciculus were involved in present study, and they were stratified into normal group (n = 9) and aphasia group (n=ll) according to the preoperative aphasia quotient (AQ). All the patients underwent surgical operation assisted by arcuate fasciculus navigator, and the high-field iMRI was performed with a 1. 5-T magnetic resonance scanner. The 3D reconstructed arcuate fasciculus images were integrated into neuronavigation system before the operation, and used by combining with functional neuronavigation under microscope during the surgical procedure. Pre operatirely, and 2-4 weeks, 3-6 months postoperative, the patients were examined with magnetic resonance scanning and aphasia quotients examination. Results Pre-operative and intra-operative arcuate fasciculus reconstruction was completed in all the 20 patients, and neuronavigation under microscope were performed after the 3D images integrated into neuronavigation system. Patients of normal AQ (94. 5 zfc5. 5) retained the normal level, except one patients who developed new conduction aphasia syndrome (AQ = 81. 8) 2-4 weeks after operation. The AQ of aphasia group (89. 4±5. 8) was significantly improved than that before operation (84. 9±8. 7, P<0. 05), except 2 patients whose language deficit was exacerbated due to tumor recurrence. The AQ of normal group (98. 3+0. 5) remained at normal level, while that of aphasia group (95. 2 ±2. 6) was significantly improved 3-6 months after operation compared with that at 2-4 weeks after operation (P<0. 05). There were no other new neurologic deficits and death in both groups. Conclusion High-field iMRI combined with functional neuronavigation is a safe and reliable technique for maximal resection of tumors adjacent to important language areas or conduction tracts, with minimal neural injury, and is beneficial to post-operative recovery.关键词
磁共振成像/弓形束/神经胶质瘤/神经导航Key words
magnetic resonance imaging/ arcuate fasciculus/ glioma/ neuronavigation分类
医药卫生引用本文复制引用
赵岩,陈晓雷,王飞,孙国臣,王宇博,宋志军,许百男..高场强术中磁共振结合语言功能神经导航技术在胶质瘤手术中的应用[J].解放军医学杂志,2011,36(7):697-700,4.基金项目
国家自然科学基金(30800349) （30800349）
广东省科技计划(2008B030301077) （2008B030301077）
北京市自然科学基金(7102145) （7102145）
