Diffusion tensor tractography combined with neuronavigation in microsurgery of insular gliomas
10.3760/cma.j.issn.1671-8925.2017.12.004
- VernacularTitle:弥散张量纤维束成像联合神经导航在岛叶胶质瘤显微切除术中的应用
- Author:
Dejun BAO
1
;
Chaoshi NIU
;
Peng CHEN
;
Wanhai DING
;
Wei CHENG
;
Chen JIANG
;
Dongxue LI
;
Xuebing JI
Author Information
1. 安徽省立医院神经外科
- Keywords:
Neuronavigation;
Diffusion tensor tractography;
Insular;
Glioma;
Microsurgery
- From:
Chinese Journal of Neuromedicine
2017;16(12):1205-1209
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the application values of diffusion tensor tractography (DTT) combined with neuronavigation in microsurgery of insular gliomas. Methods The clinical data of 27 patients with insular gliomas, admitted to our hospital from March 2013 to October 2017, were analyzed retrospectively. All DTT images were transferred to the neuronavigation system, and the three-dimensional location of tumors and pyramidal tracts were re-constructed. Surgical approaches were designed and excision scopes were defined before the surgery. Techniques on how to distinguish and protect the key blood vessels and pyramidal tracts were discussed. The treatment efficacies were analyzed. Results Total lesion resection was achieved in 22 patients (81.5％), subtotal resection in 4 (14.8％ ), and partial resection in one (3.7％ ). Postoperative pathology indicated 7 were oligodendrogliomas, and 20 were astrocytomas, including WHO grade I in one, grade II in 18, and grade III in one. One patient had transient aphasia (recovery after two weeks), 2 experienced worsened hemiplegia on opposite side of their bodies (normal after one month), and the left 24 patients remained intact function after operation. Conclusions The combination of DTT and neuronavigation is safe and effective in surgical treatment for insular gliomas, which can protect the brain function at greatest degree and maximize lesion resection, and improve the postoperative quality of life.
