基于DICOM模式与神经导航技术在儿童脑干胶质瘤中的应用

Application of DICOM and neuronavigation technology in children with brain stem glioma

摘要:

目的 探讨基于DICOM模式融合神经导航技术在儿童脑干胶质瘤显微手术中的应用价值。方法 回顾性收集2018年1月至2022年12月贵州医科大学附属金阳医院神经外科儿童脑干胶质瘤21例，术中采用头颅MRI原始数据DICOM模式通过计算机处理软件融合神经导航技术，结合术中实时电生理监测行脑干肿瘤切除术，术后判断病例的疗效。结果 20例（95.2%）肿瘤近全切除，1例（4.8%）部分切除。术后症状短期内均有缓解，围手术期内无死亡病例。随访6～48个月，平均（35±10.1）个月，Karnofsky功能状态评分标准（KPS评分）术前及术后两者差异有统计学意义（P<0.05），随访期间有5例（23.8%）恶化，其中3例死亡，总体生存率61.9%（13/21）。结论 DICOM模式融合神经导航技术能术中辅助确定脑干-肿瘤边界，电生理监测能保障患者神经功能，最大程度切除肿瘤。

关键词:DICOM模式;神经导航;儿童;脑干胶质瘤;疗效

Abstract:

Objective To explore the application value of fusion neuronavigation technology based on DICOM model in children's brain stem glioma microsurgery.Methods Twenty-one cases of children with brain stem glioma in the Department of Neurosurgery of Jinyang Hospital Affiliated to Guizhou Medical University from January 2018 to December 2022 were retrospectively collected. DICOM mode of original head MRI data was adopted, neuronavigation technology was combined with computer processing software and real-time electrophysiological monitoring brain stem tumor resection, postoperative efficacy of the cases was evaluated.Results Twenty cases (95.2%) were completely resected and 1 case (4.8%) was partially resected. The postoperative symptoms were relieved in the short term, and there were no death cases during the period. The average follow-up was 35±10.1 months from 6 to 48 months. There was a statistically significant difference between preoperative and postoperative Karnofsky Performance Status (KPS) Scale scores. During the follow-up period, 5 cases (23.8%) deteriorated, 3 of them died, and the overall survival rate was 61.9% (13/21).Conclusion DICOM model fusion neuronavigation technology can assist in determining the brain stem-tumor boundary during surgery, and electrophysiological monitoring can guarantee the nerve function of patients and maximize tumor resection.

Key words:DICOM mode;neural navigation;children;brain stem glioma;curative effect