CT血管造影结合导航技术在神经外科手术中的应用

摘要

目的 评价CT血管造影(CTA)结合导航技术在神经外科手术的应用价值.方法 回顾性分析16例通过CTA结合导航技术进行神经外科手术的病人资料,其中脑膜瘤9例,胶质瘤4例,脑动静脉畸形2例,上皮样血管内皮细胞瘤1例.术前CTA重建颅内病灶、周围血管、脑组织及颅骨图像,CTA采集的图像与Brian-lab导航系统融合,设计手术入路,术中实时指导手术.结果 脑膜瘤达Simpson Ⅰ级切除2例,Ⅱ级切除7例.胶质瘤、脑动静脉畸形和上皮样血管内皮细胞瘤均镜下全切除.结论 CTA结合导航技术能提供无创、准确的神经影像信息,指导颅内病灶切除,同时保护脑血管及脑组织,对神经外科手术有指导意义.%Objective To evaluate the value of CT angiography (CTA) in combination with Brian-lab neuronavigation system in the neurosurgery.Methods The clinical data of 16 patients undergoing neurosurgery with CTA based on neuronavigation were analyzed retrospectively.There were 9 meningiomas,4 gliomas,2 arteriovenous malformations and 1 epithelioid hemangioendothelioma in these patients.Pre-operation CTA was used to reconstruct three dimensional images of intracranial lesion and the relationship with adjacent vessels,brain tissue and the skull.Then the image of CTA was integrated into the Brian-lab navigation system,design operative approach and guide surgery.Results According to Simpson grading of meningioma resection,Grade Ⅰ resection was achieved in 2 patients and Grade Ⅱ in 7.Four gliomas,2 arteriovenous malformations and 1 epithelioid hemangioendothelioma received total removal.Conclusions Neuronavigation technique based on CTA is a noninvasive method.It can demonstrate the 3D relationship between the lesion and brain structure and precisely provide useful information for neurosurgery.