【摘要】 目的探讨弥散张量纤维束成像技术(DTT)和术中视觉诱发电位(VEP)监测在视放射区病灶手术中的应用价值。方法对6例病灶位于视放射区域的患者,手术前进行磁共振(MRI)DTT检查,了解视放射神经传导束与病灶关系;利用神经导航设定手术入路,术中行VEP监测指导手术操作。结果本组6例手术标本病理结果:2例星形胶质细胞瘤(WHOⅡ级),1例少枝胶质细胞瘤(WHOⅡ级),1例少枝-星形胶质细胞瘤(WHOⅡ级),1例间变型星形胶质细胞瘤(WHOⅢ～Ⅳ级),1例海绵状血管瘤;术后VEP检查均正常,无视觉功能障碍。结论术前进行DTT和神经导航规划,术中实时导航和VEP监测,可以在手术中有效地保护视放射,避免术后出现视觉功能障碍。更多还原

【Abstract】 Objective To investigate the applied value of diffusion tensor tractography(DTT) and visual evoked potential(VEP) for monitoring lumpectomy of lesion adjacent to the optic radiation.Methods Six patients with intracranial lesions adjacent to the optic radiation performed MRI DTT before operation in order to know relationship between the optic radiation and lesion.Neuronavigation was performed and VEP was recorded continuously during the operation.Results Pathological results of specimens showed that 2 cases were astrocytoma(WHOⅡ),1 case was oligodendroglioma(WHOⅡ),1 case was oligodendro-astrocytoma(WHOⅡ),1 case was anaplastic astrocytoma(WHOⅢ～Ⅳ),1 case was cavernous angioma.No patients were found visual deficit and VEP of 6 cases were normal postoperatively.Conclusions Combination neuronavigation with optic radiation DTT preoperatively and neuronavigation with real-time VEP intraoperatively are reliable to monitor the visual function and is helpful to perform neurosurgical planning near the visual pathway to avoid vision postoperative dysfunction.更多还原