螺旋CT血管造影及三维重建技术辅助脑深部肿瘤显微手术的应用研究

摘要

目的 探讨螺旋CT血管造影及三维重建技术(3D-CTA)在脑深部肿瘤显微手术中的应用效果.方法 回顾性分析27例经3D-CTA辅助的脑深部肿瘤显微手术病例,评估术前肿瘤的3D重建效果及术后疗效.结果 所有肿瘤的术前3D重建图像均能清楚显示病灶部位、大小、轮廓以及邻近血管、骨质,并与术中实际观察一致.27例病例全切除23例,次全切除3例,大部切除1例；术后症状改善或不变25例,症状加重或出现新的症状2例,无死亡病例；术后1个月随访优良22例.结论 3D-CTA能够准确提供肿瘤与邻近血管和颅骨的三维影像,并能够任意调整、测量及模拟手术入路,对于脑深部肿瘤选择最佳手术入路、规避术中风险的个体化治疗提供了可视化依据.%Objective To explore the application of spiral CT angiography and threedimensional reconstruction(3D-CTA) in the microsurgery of tumors in deep brain.Methods The clinical data of 27 patients with tumors in deep brain,treated by microsurgery assisted with 3D-CTA,were analyzed retrospectively to evaluate the preoperative 3D reconstruction effect and the effect after operation.Results The preoperative 3 D images of all tumors can clearly demonstrate the site,size,shape and adjacent vessels and bone,which were in accord with the facts observed during the operation.In the 27 cases,23 patients achieved gross total resection,3 patients achieved subtotal resection and 1 patients achieved partial resection;After the operation,25 patients relieved or remain the same,while 2 patients became worsen.No dead case occurred.22 cases were good during the follow up 1 month after the operation.Conclusion 3D-CTA can provide 3D images of tumor and adjacent vessels and the skull,which can also be subject to adjustment,measurement and Simulation of operation approach.It provides a visual basis for individual treatment of the tumors in deep brain to choose the best operation approach and reduce the intraoperative risk.