基于多模态影像融合的功能神经导航在脑功能区精准外科中的应用

发布时间：2018-05-25 09:47

本文选题：弥散张量成像 + 多模态影像　；参考：《蚌埠医学院》2017年硕士论文

【摘要】：目的:应用功能神经导航实现T1WI、DTI、DTT等多种模态的融合,用以指导涉及主要功能纤维束的颅内病变手术,以期达到最小化的神经功能损伤以及最大化病灶切除的效果。方法:观察2013年12月-2016年8月,我院神经外科25例脑功能区肿瘤在多模态神经导航辅助下的手术情况,随机抽取同期在传统神经导航辅助下手术切除的25例病例作为对照组。比较并分析两组手术在肿瘤全切率、术后致残率、平均住院时间、预后等方面的差异性。结果:研究组平均手术时间5.6±1.3 h,对照组平均5.4±1.5 h,差异无统计学意义(P0.05)。研究组平均住院时间16.35±4.29 d,对照组19.57±6.15 d,研究组平均住院时间明显短于对照组(P0.05)。研究组全切除19例(76%),次全切除4例,部分切除2例;对照组全切除12例(48%),次全切除9例,部分切除4例;研究组肿瘤全切除率高于对照组(P0.05)。研究组出现并发症4例(16%),对照组13例(52%),两组差异显著。研究组平均KPS评分为89.12±17.35分,对照组为73.56±18.21分,差异有统计学意义(p0.05)。结论:融合DTT等多种模态的功能神经导航,可以显著提高邻近锥体束及视放射等功能纤维束脑肿瘤的全切除率,有效降低患者术后致残率,临床疗效显著。
[Abstract]:Objective: to use functional neuronavigation to realize the fusion of T1WIN DTI DTT and other modes to guide the operation of intracranial lesions involving the main functional fibrous bundles in order to minimize the injury of nerve function and maximize the effect of lesion resection. Methods: from December 2013 to August 2016, 25 patients with brain functional area tumors in our hospital were treated with multimodal neuronavigation and 25 patients were randomly selected as control group. The difference of total tumor resection rate, postoperative disability rate, average hospitalization time and prognosis between the two groups were compared and analyzed. Results: the mean operative time was 5.6 卤1.3 hours in the study group and 5.4 卤1.5 hours in the control group. There was no significant difference between the two groups (P 0.05). The average hospitalization time was 16.35 卤4.29 days in the study group and 19.57 卤6.15 days in the control group. The average hospitalization time in the study group was significantly shorter than that in the control group (P 0.05). There were 19 cases of total resection, 4 cases of subtotal resection, 2 cases of partial resection in the study group, 12 cases of total resection, 9 cases of subtotal resection and 4 cases of partial resection in the control group. The total resection rate of tumor in the study group was higher than that in the control group (P 0.05). Complications were found in 4 cases in the study group and in 13 cases in the control group. The average KPS score was 89.12 卤17.35 in the study group and 73.56 卤18.21 in the control group. The difference was statistically significant (P 0.05). Conclusion: the fusion of DTT and other modes of functional neuronavigation can significantly improve the rate of total resection of brain tumors of the adjacent pyramidal tract and visual radiation, and effectively reduce the rate of postoperative disability, and the clinical efficacy is remarkable.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.4

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