脑功能区胶质瘤手术治疗策略进展

摘要

功能区胶质瘤的手术一直是神经外科的挑战，既要尽可能多地切除肿瘤，又要尽量保留运动语言等重要神经功能。近年来诸多新技术的应用使手术有了改观，多模态神经导航引入了功能磁共振成像以及神经纤维束的影像，提高了手术的准确性；术中磁共振成像及术中超声的优势是实时成像；清醒开颅及皮质电刺激术中功能作图技术评估神经功能最佳；应用肿瘤特异性荧光成像可在术中依靠荧光辨别肿瘤组织。以上新策略改善了手术效果，给患者带来福音。%The glioma in the functional area has always been a challenge of neurosurgery , since both maximum tumor excision and reservation of the corresponding function such as motor or speech are required . Recently,new techniques are introduced:multiple modal neuro-navigation including fMRI and DTI improves the accuracy of operation;intraoperative MRI and intraoperative ultrasound provide real time information;awake craniotomy and intraoperative mapping is the best way to assess neuro-function;tumor specific fluores-cence imaging makes the tumor glowing in the operation .All these strategies have improved the operation effect and brought good news to patients.