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目的评价高场强术中磁共振(iMRI)在胶质瘤手术中判断肿瘤残余的可靠性。方法选择2009年11月-2010年8月收治的胶质瘤患者131例,其中男69例,女62例,年龄7~79岁,平均39.6岁,均于常规导航显微镜下行肿瘤切除,切除满意后行高场强iMRI检查,将术者在显微镜下难以判断但磁共振影像上显示为肿瘤残余的部分切除并单独送病理组织学检查,而iMRI显示无残余肿瘤者术后早期复查高场强MRI,评价iMRI对残余肿瘤的检测能力。结果应用高场强iMRI可获得高质量的术中影像;剔除28例判定有肿瘤残余但因贴近功能区未继续切除的患者,结合术中切除组织病理检查与术后早期MRI复查结果,iMRI诊断残余肿瘤的敏感性为98.0%(49/50),特异性为94.3%(50/53),诊断正确率为96.1%(99/103)。结论 iMRI能获得高质量的术中影像,可作为脑胶质瘤术中判断肿瘤残余的一种安全可靠的手段。
Objective To evaluate the reliability of high-field-intensity magnetic resonance imaging (iMRI) in the determination of residual tumor in glioma surgery. Methods 131 patients with glioma who were treated from November 2009 to August 2010 were selected, including 69 males and 62 females, aged from 7 to 79 years (average 39.6 years). The tumors were resected by conventional navigation microscope and resected satisfactorily After the line of high field iMRI examination, the surgeon was difficult to judge under the microscope but the magnetic resonance imaging showed partial removals of the tumor and sent for histopathology alone, and iMRI showed no residual tumor early postoperative review High field strength MRI, evaluate the ability of iMRI to detect residual tumor. Results High-quality intra-operative MRI images were obtained using high-field intensity iMRI. Excluding 28 patients who were found to have residual tumor but did not continue resection due to close functional areas, combined with intraoperative resection histopathology and early postoperative MRI findings, iMRI diagnosis The residual tumor sensitivity was 98.0% (49/50), the specificity was 94.3% (50/53), and the diagnostic accuracy was 96.1% (99/103). Conclusion The iMRI can obtain high quality intraoperative images, which can be used as a safe and reliable method for judging the residual tumor in gliomas.