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目的探讨MRI与Dyna-CTA/3D-DSA影像融合在鞍旁跨中后颅窝肿瘤切除手术中的应用价值。方法 5例跨中后颅窝的鞍旁肿瘤,其中三叉神经鞘瘤2例,脑膜瘤2例,胆固醇样肉芽肿1例,术前行MRI与Dyna-CTA/3D-DSA三维影像融合,了解肿瘤与毗邻血管关系,其中2例将融合的数据通过Dicom格式输入神经导航系统,在神经导航及电生理监测下行肿瘤切除术。结果 5例患者手术均顺利完成,术后除1例外展神经麻痹未改善外余原有颅神经损害均恢复,且无并发症,MRI复查显示肿瘤完全切除。结论术前MRI与Dyna-CTA/3D-DSA三维融合影像,尤其是动态融合影像上,可在融合影像的冠状位、矢状位与轴位上从前到后、从左到右、从上到下了解肿瘤与毗邻血管关系,有助于减少手术对血管损伤,提高手术的全切率与安全性。
Objective To investigate the value of MRI and Dyna-CTA / 3D-DSA fusion in resection of parasellar midbrain tumors. Methods Five cases of parasellar tumors of the middle and posterior cranial fossa, including 2 cases of trigeminal schwannoma, 2 cases of meningioma and 1 case of cholesterol-like granuloma, were fused with Dyna-CTA / 3D-DSA three-dimensional images preoperatively Tumor and adjacent blood vessels, of which 2 cases of fusion data input through the Dicom format of the neural navigation system, neurotripsy and electrophysiological monitoring of tumor resection. Results All the 5 patients underwent surgery successfully. All patients except one had no improvement of cranial nerve injury except for one without external nerve paralysis. There was no complication and MR examination showed complete resection of the tumor. Conclusion The preoperative MRI and Dyna-CTA / 3D-DSA three-dimensional fusion images, especially the dynamic fusion images, can be used in the coronal, sagittal and axial fusion images from front to back, left to right, Learn about the relationship between the tumor and the adjacent blood vessels, help to reduce vascular damage surgery and improve the operation of the full rate and safety.