术中超声联合术中磁共振对脑深部肿瘤切除的初步探讨

Intraoperative ultrasound combined magnetic resonance imaging in resection of deep-seated brain leisions

  • 摘要: 目的 探讨在脑深部肿瘤手术中超声联合磁共振对肿瘤精准切除的价值。 方法 回顾性分析本院2014年7月-2015 年7月49例行术中超声及术中磁共振的脑深部肿瘤病例,其中22例术中磁共振辅助下肿瘤切除,27例术中超声联合术中磁共振辅助下肿瘤切除,对两组的肿瘤切除程度、KPS评分、手术耗时、扫描次数及脑移位进行分析。 结果 两组年龄、性别、肿瘤部位、肿瘤级别、术前KPS评分差异无统计学意义(P> 0.05)。术中超声联合术中磁共振组肿瘤切除程度92.01%±6.17%,KPS评分76.15±10.36,手术耗时(2.9±0.6) h,扫描次数1.29±0.43,优于单独术中磁共振组,但两组肿瘤切除程度及KPS评分差异无统计学意义。3例切开硬膜后明显脑移位患者,超声辅助下纠正脑移位,肿瘤切除满意。 结论 术中超声的应用可以减少磁共振扫描次数,缩短手术时间,实时纠正脑漂移,完成肿瘤切除。

     

    Abstract: Objective To investigate the value of magnetic resonance imaging combined with intraoperative ultrasound in resection of deep-seated brain tumors. Methods A retrospective analysis in 49 patients who underwent deep-seated brain tumors resection by magnetic resonance imaging alone or combined with intraoperative ultrasound in our hospital from July 2014 to July 2015 was carried out.Of the 49 cases, 22 cases were treated with intraoperative magnetic resonance imaging assisted tumor resection, 27 cases with intraoperative magnetic resonance imaging combined intraoperative ultrasound assisted tumor resection.The tumor resection extent, KPS score, surgical time, scanning times and brain shift were analyzed. Results There were no statistically significant differences in age, gender, tumor location, tumor grade, preoperative KPS score between two groups (P> 0.05).The tumor resection extent, KPS score, surgical time and scanning times in research group were (92.01%±6.17%), (76.15 ±10.36), (2.9±0.6) h, (1.29±0.43), respectively, which were all better than intraoperative magnetic resonance imaging group, while no significant differences were found in tumor resection extent and KPS scores between two groups.There were 3 cases with brain shift after dural incision, and they were corrected under ultrasound with satisfactory results. Conclusion Application of intraoperative ultrasound can reduce the scanning times of magnetic resonance imaging, shorten surgical time, correct the brain shift in time and complete the tumor resection effectively.

     

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