Application Of Intra-operative Magnetic Resonance Imaging Navigation In Resection Of Gliomas In The Functional Areas

ObjectiveStudy the clinical value of iMRI navigation in functional areas glioma surgery.MethodsCollecting176cases who went function areas glioma surgery from December2012to December2013.IMRI navigation group contained86cases, male47cases, female39cases,14～72years,average age was (54.6±6.8)years. The pathological types: star celltumor36cases, modified star cell tumor15cases, glioblastoma14cases,oligodendrocytes tumor13cases, mixed glioma (star cell tumor and oligodendrocytestumor)8cases. Pathology classification: Ⅱ level32cases, between Ⅱand Ⅲ level16cases, Ⅲ level13cases,Ⅳ level25cases. course of disease:1month to72months,average (12±6.3)months. clinical manifestation:70cases had symptoms ofIncreased intracranial pressure (headache, vomiting, papillary edema, visual acuityvision change, diplopia).47cases had the local symptoms such as Physical activitybarriers, partial body feels obstacle, aphasia, epilepsy.13cases complicated withdiabetes mellitus,27cases complicated with hypertension,5cases complicated withcoronary heart disease.Conventional operation group contained90cases, male51cases,female39cases,17～74years, average age was (56.1±8.2)years. The pathological types: star cell tumor43cases, modified star cell tumor20cases, glioblastoma15cases,oligodendrocytes tumor8cases, mixed glioma (star cell tumor and oligodendrocytestumor)4cases. Pathology classification: Ⅱ level36cases, between Ⅱand Ⅲ level14cases, Ⅲ level17cases,Ⅳ level23cases. course of disease:1month to86months,average (13±5.7)months. clinical manifestation:78cases had symptoms ofIncreased intracranial pressure (headache, vomiting, papillary edema, visual acuityvision change, diplopia).53cases had the local symptoms such as Physical activitybarriers, partial body feels obstacle, aphasia, epilepsy.15cases complicated withdiabetes mellitus,26cases complicated with hypertension,3cases complicated withcoronary heart disease.The two groups had no statistical difference in gender, age, pathological typeand pathological grading, course, clinical manifestations and complications.All patients underwent MRI or CT examination in the preoperative andpostoperative for10days. Calculated the volume of residual tumor after surgery.Removal rate of100%was total removal. Removal rate of of85%~99%wassubtotal resection, Removal rate of70%~84%was most resection, less than70%was partial removal. Evaluated the situation of function recovery after the operation:define recovery well as the symptoms were improved or the was no change; definerecovery worse as the symptoms turn worse, produced new nerve dysfunction ordeath. It was good that postoperative complications (fever, intracranial infection,cerebrospinal fluid leakage, hemiparesis, sensory dysfunction, aphasia) was less, Kpsscore increased or changeless, preoperative symptoms improve or no change. It wasworse that postoperative complications (fever, intracranial infection, cerebrospinalfluid leakage, hemiparesis, sensory dysfunction, aphasia) was more, Kps scoredecreased, preoperative symptoms aggravated, turned new neural dysfunction ordeath. ResultsiMRI navigation group61cases, subtotal resection was12cases, resection inmostly was9cases, partial resection was4cases, the full cutting rate was70.9%;Regular group40cases, subtotal resection was18cases, resection in mostlywas19cases, partial resection was13cases, the full cutting rate was44.4%.thedifferences between the two groups were statistical significant (P<0.05).78patientsof iMRI navigation group had good prognosis,8cases deteriorated,the rate of goodprognosis was90.7%;65patients of regular group had good prognosis,25casesdeteriorated, the rate of good prognosis was72.2%.The differences between the twogroups were statistical significant (P <0.05).Conclusion1. IMRI navigation can enhance the total resection rate of gliomas in thefunctional areas of the brain and improve the prognosis of patients.2. IMRI navigation has the feature of small trauma and fewer complications.