摘要
目的术中磁共振成像(intraoperative Magnetic Resonance Imaging,iMRI)系统是近年来日渐兴起的先进神经外科手术辅助设备,在垂体腺瘤的微侵袭手术中起到关键作用。文中探讨运用iMRI辅助大型侵袭性垂体腺瘤手术的临床应用价值。方法大型侵袭性垂体腺瘤患者20例,男8例,女12例,经鼻-蝶肿瘤切除术18例,开颅肿瘤切除术2例,均在iMRI系统辅助下行肿瘤显微切除术。术中行MRI扫描1～2次。若术中扫描提示肿瘤残留,则借助iMRI定位并指导手术再次切除残余肿瘤。结果 iMRI扫描发现肿瘤残留者8例,其中6例(30%)做进一步切除;经iMRI再次扫描证实其中4例达全切除,另2例达次全切除;最终16例肿瘤获全切除,4例肿瘤达次全切除,肿瘤的全切率由60%提高至80%,未发现与iMRI相关的并发症。结论 iMRI能有效判断垂体腺瘤的切除程度,为手术结果的实时判断提供客观依据,从而在提高手术精确性和安全性的同时,提高了肿瘤的全切率。
Objective Intraoperative magnetic resonance imaging （ iMRI）, an advancing ancillary technique in neurosurgical procedures for the past few years, is playing a key role in microsurgery for invasive pituitary adenoma. The purpose of this study is to explore the practicability of the resection of large invasive pituitary adenoma by the iMRI-assisted microsurgery and its clinical effects. Methods The microsurgeries assisted by iMRI were performed in 20 patients （8 male and 12 female）, including 18 transsphenoidal pituitary adenoma resections and 2 craniotomies. The number of scans ranged from 1 to 2 per surgery. The residual tumors revealed by iMRI were further removed. Results In 8 cases, intraoperative imaging revealed residual tumors, 6 of them needed further resections. With the guidance of iMRI, the percentage of gross total removal increased from 60% to 80%. Total and subtotal removals of tumors were achieved respectively in 16 and 4 cases. There was no iMRI-related complication. Conclusion The extent of tumor resection can be assessed effectively by iMRI. Therefore, maximizing the resection of the lesion and minimizing the injury to neurological function can be achieved by iMRI.
出处
《医学研究生学报》
CAS
北大核心
2013年第1期49-51,共3页
Journal of Medical Postgraduates
关键词
垂体腺瘤
侵袭性
术中磁共振成像
显微外科手术
Pituitary adenoma
Invasion
Intraoperative magnetic resonance imaging
Microsurgery
