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目的探讨立体定向活检手术在大脑胶质瘤病诊断中的应用价值,提高大脑胶质瘤病的诊断水平。方法对影像学显示颅内病灶侵犯2个以上脑叶的患者行立体定向活检术。安装日本驹井式或Leksell立体定向头架,行CT或MRI增强扫描,利用“四点一线手算法”确定包含入颅点、靶点及靶点前后各10mm点共四个点的三维长轴,或采用计算机辅助立体定向手术系统(CAPN)计算靶点坐标及规划活检入颅。所取标本送病理学检查。结果经病理证实,17例诊断为大脑胶质瘤病,其中星形细胞瘤Ⅰ级3例,Ⅱ级8例,Ⅱ～Ⅲ级2例,Ⅲ级4例。未出现因活检手术而造成的出血、偏瘫等严重并发症。17例患者术后均给予相应的治疗。结论立体定向活检术对于明确诊断大脑胶质瘤病,具有重要的应用价值。
Objective To investigate the value of stereotactic biopsy in the diagnosis of gliomatosis and to improve the diagnosis of gliomatosis. Methods Stereotactic biopsy was performed on patients with intracranial lesions involving more than two lobes in imaging studies. Install Japanese komata type or Leksell stereotactic head rack, line CT or MRI enhanced scan, using the “four-point and one hand algorithm” to determine the inclusion of the cranial point, the target point and before and after the 10mm point of a total of four points Three-dimensional long axis, or the use of computer-assisted stereotactic surgery system (CAPN) to calculate the coordinates of the target and planning biopsy into the skull. The specimens taken for pathological examination. Results Pathologically, 17 cases were diagnosed as gliomatosis. There were 3 cases of grade Ⅰ in astrocytoma, 8 cases of grade Ⅱ, 2 cases of grade Ⅱ ~ Ⅲ and 4 cases of grade Ⅲ. No bleeding, hemiplegia and other serious complications due to biopsy were not seen. 17 patients were given the appropriate treatment. Conclusion Stereotactic biopsy has an important value in the diagnosis of gliomatosis.