神经导航系统在脑深部肿瘤显微手术中的应用

目的 评价神经导航系统在脑深部肿瘤显微手术中的应用价值。方法 应用Stealth Navigation神经导航系统对46例脑深部肿瘤手术治疗，术前采用神经影像MRI导航扫描，对病灶进行三维重建，制定显微手术治疗计划，术中实时导航指导手术切除范围，分析治疗效果。结果 肿瘤及其周围结构定位准确，手术全切除39例（84．7％），次全切除3例（6．6％），大部分切除4例（8．7％）；术后症状改善或不变41例（89．1％），症状加重或出现新症状5例（10．9％），无死亡病例。结论 应用神经导航系统可以精确定位脑深部肿瘤，设计最佳手术人路，有助于提高显微手术疗效，防止手术副损伤，降低手术并发症。

Application of neuronavigation in resection of intracranial deep tumor

Objective To evaluate the utility of neuronavigation system for resection of intracranail deep tumor. Methods A retrospective review of 46 cases of intra-cranial deep lesions were used frameless stereotaxy systems. Data of MRI and fMRI were entered into the neuronavigation systems and analyzed. A 3-D simulation of model of cranium was reestablished and operative approach was designed. During the operation, the lesion can be located accurately. Removal range were decided. The clinical data and postoperative outcome were analized. Results The tumor and its surrounding structure were located accurately. In 46 cases of lesionectomy operations, total lesion removal was achieved in 39 cases (84.7%), subtotal removal in 3 cases (6.6%), most partial removal in 4 cases (8.7%). Neurological symptoms improved or unchanged in 41 cases (89.1%), postoperative neurological symptoms becamed severe or new deficience of neuronal function appeared in 5 cases (10.9%). No operative death occurre. Conclusion Neuronavigation system is very helpful for brain for the cases with lesions located deep in the brain. Its accuracy of location is very important in protecting normal brain tissues and decrease surgical complication.