摘要
目的探讨术中磁共振成像(iMRI)在儿童后颅窝占位性病变切除术中应用的可行性、安全性及其对病变全切除率的影响。方法回顾性分析2019年3月至2021年3月复旦大学附属华山医院神经外科采用iMRI辅助后颅窝占位切除术治疗的27例患儿的临床资料,观察iMRI相关耗时、病变全切除率、不良事件及术后并发症的发生情况。将iMRI显示病变无残留定义为全切除;残留病变体积≤20%为大部切除。结果27例患儿均安全完成手术及iMRI检查。27例患儿单次iMRI的相关总耗时为(58.5±11.6)min(43~87 min)。27例患儿首次iMRI结果显示,24例(88.9%)为病变全切除,3例(11.1%)为大部切除;其中2例进一步切除病变,第2次iMRI显示病变均全切除。应用iMRI后病变全切除率提高至96.3%(26/27)。术中3例患儿发生麻醉相关不良事件,iMRI扫描过程中无不良事件发生。术后无一例发生颅内感染;仅1例(3.7%)发生切口感染、愈合不良。结论在儿童后颅窝占位性病变切除术中应用iMRI具有可行性,可提高病变全切除率,且不增加手术的相关风险和并发症。
Objective To investigate the feasibility and safety of intraoperative magnetic resonance imaging(iMRI)in the resection of children′s space-occupying lesions in the posterior cranial fossa and its effect on the total resection rate of the lesions.Methods The clinical data of 27 children who underwent iMRI-assisted resection of space-occupying lesions in the posterior fossa in the Department of Neurosurgery,Huashan Hospital,Shanghai Medical College,Fudan University from March 2019 to March 2021 were retrospectively analyzed.We documented the information including iMRI-related time-consuming,total lesion resection rate,adverse events and postoperative complications.Total resection was defined as no residual lesion on iMRI;subtotal resection was defined as residual lesion volume of≤20%on iMRI.Results All 27 patients underwent the operation and iMRI safely.The relevant total time for a single iMRI of the 27 children was 58.5±11.6 min(43-87 min).The first iMRI results of the 27 children showed that 24(88.9%)had total resection of the lesions;three(11.1%)had subtotal resection;two of them underwent further resection,and the second iMRI showed that both lesions were completely resected.The total resection rate of lesions increased to 96.3%(26/27)after applying iMRI.Anesthesia-related adverse events occurred in 3 children during the operation,and no adverse events occurred during the iMRI scan.No intracranial infection occurred after operation;only 1 case(3.7%)had incision infection and poor healing.Conclusion It is feasible to apply iMRI in the resection of space-occupying lesions in the posterior cranial fossa in children,which can improve the total resection rate of the lesions without increasing the associated risks and complications of surgery.
作者
张超
丁兴华
张荣
Zhang Chao;Ding Xinghua;Zhang Rong(Department of Neurosurgery,Huashan Hospital,Shanghai Medical College,Fudan University,Shanghai 200040,China;National Center for Neurological Disorders,Shanghai 200040,China;Neurosurgical Institute of Fudan University,Shanghai 200040,China;Shanghai Clinical Medical Center of Neurosurgery,Shanghai 200040,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2022年第7期653-657,共5页
Chinese Journal of Neurosurgery
关键词
磁共振成像
颅窝
后
神经外科手术
儿童
肿瘤
Magnetic resonance imaging
Cranial fossa,posterior
Neurosurgical procedures
Child
Neoplasms
