INC国际-中文版中文
胶质瘤
预约INC国际专家
寻求第二诊疗意见
治疗胶质瘤联系电话400-029-0925

INC为您呈现

世界神经外科一手前沿资讯

INC国际 > 学术交流 > 学术论文 >

小儿神经外科术中磁共振成像:安全和实用

编辑:INC|发布时间:2019-11-13 15:22|点击次数:
Intraoperative magnetic resonance imaging in pediatric neurosurgery: safety and utility
小儿神经外科术中磁共振成像:安全和实用
  英文摘要:

  Objective The use of high-field intraoperative MRI has been largely studied for the treatment of intracranial tumors in adult patients. In this study, the authors investigated the safety, advantages, and limitations of high-field iMRI for cranial
neurosurgical procedures in pediatric patients, with particular attention to craniopharyngiomas and gliomas.
 
  Methods The authors performed 82 surgical procedures in patients under 16 years of age (range 0.8–15 years) over an 8-year period (2007–2014) using iMRI. The population was divided into 3 groups based on the condition treated: sellar region tumors (Group 1), gliomas (Group 2), and other pathological entities (Group 3). The patients’ pre- and postoperative neurological status, the presence of residual tumor, the number of intraoperative scans, and complications were evaluated.
 
  Results In Group 1, gross-total resection (GTR) was performed in 22 (88%) of the procedures and subtotal resection (STR) in 3 (12%). In Group 2, GTR, STR, and partial resection (PR) were performed, respectively, in 15 (56%), 7 (26%), and 5 (18%) of the procedures. In Group 3, GTR was performed in 28 (93%) and STR in 2 (7%) of the procedures. In cases of craniopharyngioma (Group 1) and glioma (Group 2) in which a complete removal was planned, iMRI allowed localization of residual lesions and attainment of the surgical goal through further resection, respectively, in 18% and 27% of the procedures. Moreover, in gliomas the resection could be extended from partial to subtotal in 50% of the cases. In 17% of the patients in Group 3, iMRI enabled the identification and further removal of tumor remnants. There was no intra- or postoperative complication related to the use of iMRI despite special technical difficulties in smaller children.
 
  Conclusions In this study, the use of iMRI in children proved to be safe. It was most effective in increasing the extent of tumor resection, especially in patients with low-grade gliomas and craniopharyngiomas. The most prominent disadvantage of high-field iMRI was the limitation with respect to operative positioning due to the configuration of the surgical table.

  中文摘要:
 
  目的:探讨高场强术中MRI在成人颅内肿瘤治疗中的应用。在这项研究中,作者研究了高场iMRI的安全性、优点和局限性。神经外科手术在小儿患者中的应用,尤其要注意颅咽管瘤和胶质瘤
 
  方法:对16岁以下(0.8-15岁)8年间(2007-2014)82例患者行iMRI手术治疗。The 人口 分成 3 组 根据 条件 treated: sellar 地区 肿瘤 (Group 1 ), 神经胶质瘤 (Group 2 ), 和 其他 病理 实体 (Group 3 ). The patients’ pre 和 postoperative 神经 status, 存在 残余 tumor, 术 中 评价 scans, 和 并发症 的 数量
 
  结果:第1组22例(88%)行全切(GTR), 3例(12%)行次全切(STR)。在第2组中,15例(56%)、7例(26%)和5例(18%)分别进行了GTR、STR和部分切除(PR)。在第三组中,28例(93%)进行了GTR治疗,2例(7%)进行了STR治疗。In 例 颅 咽 管瘤 (Group 1 ) 和 神经胶质瘤 (Group 2 ) 的 一 个 完整 切除 是 planned, iMRI 允许 localization 残余 病灶 , 达到 手术 目的 通过 进一步 resection, respectively, 在 18% 和 27%
的程序。此外,在神经胶质瘤中,50%的病例可以将切除范围从局部扩大到次全切除。在第三组17%的患者中,iMRI能够识别并进一步清除肿瘤残留。尽管在较小的儿童中存在特殊的技术困难,但没有与iMRI使用相关的内部或术后并发症。
 
  结论:在本研究中,儿童使用iMRI是安全的。它在增加肿瘤切除范围方面最有效,尤其是对低级别胶质瘤和颅咽管瘤患者。高场强iMRI最突出的缺点是手术台的结构限制了手术定位。
 
神经胶质瘤

INC国际神经外科医生集团,国内脑瘤患者治疗新选择,足不出户听取世界神经外科大咖前沿诊疗意见不是梦。关注“INC国际神经科学”微信公众号查看脑瘤治疗前沿资讯,健康咨询热线400-029-0925,点击立即预约在线咨询直接预约INC国际教授远程咨询!

相关阅读

患者故事

上一个
下一个
了解更多
在线咨询INC