磁共振T2Flair像下扩大切除脑胶质母细胞瘤对预后的影响

发布时间：2018-03-02 23:20

本文选题：胶质母细胞瘤　切入点：TFlair　出处：《广东医学》2017年14期 　论文类型：期刊论文

【摘要】：目的探究在磁共振T2Flair序列范围下扩大对脑胶质母细胞瘤(GBM)的切除对患者预后的影响。方法回顾性分析41例在唤醒麻醉下进行颅内GBM切除的患者,其中17例MRI T2Flair序列范围下扩大切除脑GBM(观察组),24例T1增强像下切除GBM(对照组)。所有病例手术过程中应用术中神经导航结合DTI、皮层电刺激、术中超声、术中肿瘤荧光造影等多种辅助手段,术后病理均确诊为GBM。所有患者随访至2017年1月。结果对照组24例T1增强病灶均全部切除,术后无患者出现神经功能障碍,17例T2Flair切除GBM患者,中位生存时间为30.45个月,对照组中位生存时间为15.37个月,两组差异有统计学意义(X~2=6.16,P=0.013)。结论唤醒麻醉下应用术中神经导航结合DTI、皮层电刺激、术中超声、术中肿瘤荧光造影等多种辅助手段有效保障了颅内GBM患者的手术安全性,提高了T1增强像的病灶全切率,可以最大安全范围完成T2Flair的扩大切除,可明显延长GBM患者的生存期。
[Abstract]:Objective to investigate the effect of extended resection of glioblastoma (GBM) in T2Flair sequence on the prognosis of patients. Methods 41 patients undergoing intracranial GBM resection under arousal anesthesia were retrospectively analyzed. In 17 cases of MRI T2Flair sequence, GBM was resected by extended brain resection (observation group, 24 cases with T1-enhanced imaging). All cases were treated with intraoperative neuronavigation combined with DTI, cortical electrical stimulation, intraoperative ultrasound, intraoperative neuronavigation and DTI. All the patients were followed up until January 2017. Results all the 24 patients in the control group were excised completely with T1 enhancement focus, and 17 patients with GBM were resected without neurological dysfunction after operation. The median survival time was 30.45 months in the control group and 15.37 months in the control group. The difference between the two groups was statistically significant. Conclusion under arousal anesthesia, intraoperative neuronavigation combined with DTI, electrical stimulation of cortex and intraoperative ultrasound were used. Various assistant methods such as intraoperative fluorography can effectively protect the surgical safety of patients with intracranial GBM, improve the total resection rate of T1-enhanced lesions, can complete the extended resection of T2Flair in the maximum safe range, and can significantly prolong the survival time of patients with GBM.
【作者单位】：广东三九脑科医院神经外五科;广东三九脑科医院肿瘤综合治疗中心;
【基金】：广东省医学科研基金资助项目(编号:B2015106)
【分类号】：R739.41

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