基于3.0T磁共振注册的神经导航系统在无框架立体定向颅内病变活检术中的应用研究

doi:10.12114/j.issn.1007-9572.2022.0318

中国全科医学 ›› 2022, Vol. 25 ›› Issue (29): 3686-3690.DOI: 10.12114/j.issn.1007-9572.2022.0318

基于3.0T磁共振注册的神经导航系统在无框架立体定向颅内病变活检术中的应用研究

黄啸元, 乌拉别克·毛力提, 阿布都克尤木·吉力力, 王继超^*(), 杨小朋

830001　新疆维吾尔自治区乌鲁木齐市，新疆维吾尔自治区人民医院神经外科

收稿日期:2022-03-30 修回日期:2022-05-15 出版日期:2022-10-15 发布日期:2022-07-14
通讯作者: 王继超
黄啸元，乌拉别克·毛力提，阿布都克尤木·吉力力，等.基于3.0T磁共振注册的神经导航系统在无框架立体定向颅内病变活检术中的应用研究[J].中国全科医学，2022，25（29）：3686-3690，3697.[www.chinagp.net]
作者贡献：黄啸元提出研究思路并设计研究方案；乌拉别克·毛力提负责资料收集；阿布都克尤木·吉力力进行数据核实；王继超、杨小朋负责文章的质量控制及审校。
基金资助:
国家自然科学基金资助项目(82060316)

Application of a Neuronavigation System Utilizing 3.0T Magnetic Resonance Imaging in Frameless Stereotactic Brain Biopsies

Xiaoyuan HUANG, Maoliti WULABIEKE·, Jilili ABUDUKEYOUMU·, Jichao WANG^*(), Xiaopeng YANG

Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China

Received:2022-03-30 Revised:2022-05-15 Published:2022-10-15 Online:2022-07-14
Contact: Jichao WANG
About author:
HUANG X Y, WULABIEKE M, ABUDUKEYOUMU J, et al. Application of a neuronavigation system utilizing 3.0T magnetic resonance imaging in frameless stereotactic brain biopsies[J]. Chinese General Practice, 2022, 25 (29) : 3686-3690, 3697.

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摘要/Abstract

摘要： 背景随着现代神经影像学和神经导航技术的进步，无框架脑活检技术在当今越来越普及。目的探讨基于3.0T磁共振注册的神经导航系统在无框架立体定向颅内病变活检术中的应用。方法选取2018年3月至2021年6月在新疆维吾尔自治区人民医院神经外科住院的27例颅内病变患者为研究对象，患者术前行3.0T磁共振扫描，注册并应用美敦力Stealth S7神经导航系统行无框架立体定向颅内病变活检术。回顾性分析患者的术前资料、术后并发症、病理诊断率等资料。结果对27例患者进行了无框架立体定向颅内病变活检术，其中间变性星形细胞瘤占33.3%（9/27），大B细胞淋巴瘤占18.5%（5/27）。26例（96.3%）患者经立体定向活检术明确病理诊断，术中穿刺道出血发生率为7.4%（2/27）；术后并发症发生率为18.5%（5/27），术后颅内出血发生率为14.8%（4/27），术后肺部感染发生率为3.7%（1/27）；无死亡病例。结论基于3.0T磁共振注册的神经导航系统下无框架立体定向颅内病变活检术是一种安全有效的方法，具有较高的诊断率。

关键词: 脑疾病, 神经导航, 磁共振成像, 影像引导活检, 神经胶质瘤, 星形细胞瘤, 手术后并发症

Abstract:

Background

With the advancement of modern neuroimaging and neuronavigation techniques, frameless intracranial biopsy techniques have been increasingly used.

Objective

To assess the application value of a neuronavigation system using 3.0T magnetic resonance imaging (MRI) in frameless stereotactic brain biopsies.

Methods

Twenty-seven patients with intracranial lesions were recruited in the Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region from March 2018 to June 2021. All of them underwent brain MRI at 3.0T, then registered for using the Medtronic Stealth Station S7 neuronavigation system to implement frameless stereotactic brain biopsies. Pre-biopsy data, post-biopsy complications and pathological diagnosis rate were reviewed retrospectively.

Results

In all, 27 biopsies were performed in these 27 cases, among which anaplastic astrocytoma and large B-cell lymphoma accounted for 33.3% (9/27) , and 18.5% (5/27) , respectively. Twenty-six cases obtained a definite diagnosis by frameless stereotactic brain biopsies, with a rate of pathological diagnosis of 96.3%. During the brain biopsy, puncture tract bleeding occurred in two cases (7.4%) , and one of them was confirmed with serious bleeding by post-biopsy brain CT. Five cases had post-biopsy complications (18.5%) , four of them had intracranial hemorrhage (14.8%) , and the other one case had pulmonary infection (3.7%) . No death occurred in the biopsy.

Conclusion

This kind of frameless stereotactic brain biopsy is safe and effective with a high diagnostic rate.

Key words: Brain diseases, Neuronavigation, Magnetic resonance imaging, Image-guided biopsy, Glioma, Astrocytoma, Postoperative complications

黄啸元,乌拉别克·毛力提,阿布都克尤木·吉力力,等. 基于3.0T磁共振注册的神经导航系统在无框架立体定向颅内病变活检术中的应用研究[J]. 中国全科医学, 2022, 25(29): 3686-3690. DOI: 10.12114/j.issn.1007-9572.2022.0318.
Xiaoyuan HUANG,Maoliti WULABIEKE·,Jilili ABUDUKEYOUMU·, et al. Application of a Neuronavigation System Utilizing 3.0T Magnetic Resonance Imaging in Frameless Stereotactic Brain Biopsies[J]. Chinese General Practice, 2022, 25(29): 3686-3690. DOI: 10.12114/j.issn.1007-9572.2022.0318.

图/表 3

图1 神经导航系统下无框架立体定向颅内病变活检术步骤注：A为将患者核磁序列导入神经导航系统，并设定穿刺靶点及路径；B为根据活检计划定位穿刺点；C为按步骤穿刺取出多块活检标本

Figure 1 Procedure for using the neuronavigation system with 3.0T magnetic resonance imaging to implement frameless stereotactic brain biopsy

图2 双侧额叶、右颞叶、胼胝体区巨大占位患者行神经导航系统下无框架立体定向颅内病变活检术注：33岁男性患者，双侧额叶、右颞叶、胼胝体区巨大占位，无框架立体定向下行病变活检，术中可见穿刺道有少量出血，术后当日复查颅脑CT提示穿刺靶点周围少量出血，病理诊断为星形胶质细胞瘤

Figure 2 Frameless stereotactic brain biopsy using the neuronavigation system with 3.0T magnetic resonance imaging performed in a patient with massive lesions of the bilateral frontal lobes，right temporal lobe，and the corpus callosum

图3 胼胝体占位患者行神经导航系统下无框架立体定向颅内病变活检术注：18岁女性患者，胼胝体占位，无框架立体定向下行病变活检，术中可见穿刺道有少量出血，术后患者出现昏迷，急查颅脑CT提示瘤内及脑室大量出血，急诊行脑室钻孔引流术，病理诊断为星形胶质细胞瘤。患者意识恢复后出院，2 d后病变再次出血入院，行肿瘤切除，最终病理诊断为胶质母细胞瘤

Figure 3 Frameless stereotactic brain biopsy using the neuronavigation system with 3.0T magnetic resonance imaging performed in a patient with lesions of the corpus callosum

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基于3.0T磁共振注册的神经导航系统在无框架立体定向颅内病变活检术中的应用研究

Application of a Neuronavigation System Utilizing 3.0T Magnetic Resonance Imaging in Frameless Stereotactic Brain Biopsies

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