摘要
目的：探讨多模态镜下导航联合高场强术中磁共振成像系统在颅底中央区复杂病变处理中的应用价值及初步经验。方法：对19例颅底中央区复杂病变应用多模态镜下导航结合术中磁共振辅助进行显微外科治疗，术前将患者影像学信息导入神经导航系统进行三维重建，根据重建影像设计手术切口。手术方式采取经颅入路和经颅外人路，后者包括经口鼻蝶入路和经鼻蝶人路。术中将影像学二维／三维图像投射到术野中，指导手术操作，术中磁共振扫描判断肿瘤切除程度，同时更新导航资料，制定下一步处理计划。结果：镜下导航所示位置与实际情况基本一致。术中MRI扫描1-2次，14例发现肿瘤全切，5例残留，其中2例根据术中扫描更新导航资料并进一步手术切除，未发生与术中MRI相关的并发症或安全事故。结论：应用显微镜下导航技术联合术中磁共振辅助，为手术中实时判断肿瘤切除程度及其他可能发生的意外提供了客观依据，提高了肿瘤显微手术切除程度和手术安全性。
Objective：To evaluate the applicative value of multimodal navigation combined with intraoperative magnetic resonance imaging system in the treatment of complex lesions of middle skull base. Method：Nineteen con-secutive patients undergoing complex lesions resection using multimodal microscopic navigation combined with iM-RI were included. Preoperative radiological images were imported into navigation planning system, based on which approach and microsurgical window were designed. Transcranial approach and extracranial approach（include trans-oral-nasal-sphenoidal approach and transsphenoidal approach） were performed in our series. After presumptively total resection were finished, introperative magnetic resonance （iMRI）were performed, followed by navigation im-ages updating, and continuing resection if necessary. Result：iMRI scan were performed from l time to 2 times. In 5 cases with residual seen on iMRI scan, continued resection were carried on in 2 of them . There was no iMRI-asso- ciated complications. Conclusion：Microscopic-based neurovigation,in combination with intraoperative magnetic res onance, could provide objective basis for resection, and improve the safety level of tumor resection.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2014年第4期246-248,251,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
中央颅底
显微镜下导航
术中磁共振成像
middle skull base
microscopic-based neurovigation
intraoperative magnetic resonance imaging
