【摘要】 目的探讨术中磁共振影像(iMRI)神经导航技术在经鼻-蝶垂体瘤切除手术中的应用。方法在PoleStar N20 iMRI神经导航系统辅助下施行经鼻-蝶垂体瘤切除术42例。对临床资料、iMRI成像情况及其对手术进程和手术结果的影响等进行分析。结果术中扫描2～5次,平均(2.5±0.87)次。术中扫描发现肿瘤残留13例,其中2例因肿瘤包绕颈内动脉未进一步切除,另11例进一步切除后,达到影像学肿瘤全切除6例,次全切除5例。最终肿瘤的全切除率从69.0%提高到83.3%。无与iMRI相关的并发症。结论经鼻-蝶垂体瘤切除术中应用iMRI神经导航技术,为手术进程的指导及手术结果的实时判断提供了客观依据,从而提高了肿瘤的全切除率。更多还原

【Abstract】 Objective To explore use of intraoperative MR image(iMRI)-based neuronavigation in the transsphenoidal surgery for pituitary adenoma.Methods Forty-two pituitary adenomas were resected via endonasal-transsphenoidal approach using the PoleStar N20 iMRI neuronavigation system.The clinical materials,iMRI acquisition and its influence on the surgical process and operative results were analyzed.Results The times of intraoperative scanning ranged from 2-5 per surgery,averaging 2.5±0.87 times.Among the 42 patients,iMRI revealed residual tumor in 13,2 of which were unable to further being resected due to the internal carotid artery being enclosed by tumor,another 11 underwent further resection with total removal in 6 patients and subtotal in 5.Finally,the rate of gross total removal increased from 69.1% to 83.3%.There was no iMRI-related complication.Conclusion iMRI-based neuronavigation provides objective information for guidance of surgical procedure and the real-time judgment of surgical results,which leads to a higher percentage of tumor removal in transsphenoidal surgery.更多还原