摘要
目的探讨高场强术中磁共振（iMRI）在立体定向脑内血肿抽吸引流术中的应用价值。方法对11例天津医科大学总医院神经外科2011年8月至2012年1月收治的高血压脑出血患者术前行常规MRI及弥散张量成像（DTI）扫描，运用软件重建皮质脊髓束（CST），分析CST与血肿三维关系并制定手术方案。行计算机辅助立体定向脑内血肿抽吸引流手术，适时在术中行MRI扫描，根据血肿清除程度，结束手术或者更新手术计划后继续清除。术后3周复查常规MRI及DTI，对比分析患者手术前后CST完整性。结果所有患者全部存活，无严重手术并发症，运动功能、CST完整性较术前均有不同程度改善。结论重建CST并三维显示CST、血肿与周围重要组织毗邻关系，既能辅助制定最优手术路径，也能评估患者预后。高场强iMRI可在手术全程监控颅内状况，提高血肿清除率，降低术后并发症发生率。
Objective To explore the application values of high-field intraoperative magnetic resonance imaging （MRI） in stereotactic aspiration and drainage of hypertensive hematomas. Methods During a period of August 2011 to January 2012, 11 patients with hypertensive hemorrhage were examined preoperatively by conventional MRI and diffusion tensor imaging （DTI） with 1.5T intraoperative MRI system （Signa HDi, GE, USA） at Tianjin Medical University General Hospital. The anatomic relationship of corticospinal tract （CST） and hematoma was used for the operative planning with the neuronavigation planning workstation （iPlan Cranial 3.0 software, BrainLab, Germany） for 3D reconstruction. During stereotactic surgery, intraoperative MRI scan was performed. According to the clearance rate of hematomas, the operators decided to finish the operation or update the operative planning to continue hematoma removal. All patients were reexamined by conventional MRI and DTI at Week 3 postoperation. Then comparative analysis was performed for the preoperative and postoperative integrity of CST. Results No death or severe complications occurred. All patients showed improvement of motor function and the postoperative integrity of CST. Conclusion The intracranial condition may be monitored effectively by intraoperative MRI throughout surgery so as to increase the rate of hematoma removal and reduce the postoperative complications.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第35期2491-2494,共4页
National Medical Journal of China
基金
基金项目：天津市科委科学基金（12JCYBJC16900）
关键词
颅内出血
高血压性
磁共振成像
弥散张量成像
Intracranial hemorrhage, hypertensive
Magnetic resonance imaging
Diffusion tensor imaging
