Clinical evaluation of resection of functional area gliomas guided by intraoperative 3.0 T MRI combined with functional MRI navigation

IF 1.6 3区医学 Q2 SURGERY

BMC Surgery Pub Date : 2024-07-27 DOI:10.1186/s12893-024-02506-z

Luoyi Tian, Nan Peng, Zhongrun Qian, Jinpeng Hu, Wei Cheng, Yanghua Xia, Chuandong Cheng, Ying Ji

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Abstract

In assessing the clinical utility and safety of 3.0 T intraoperative magnetic resonance imaging (iMRI) combined with multimodality functional MRI (fMRI) guidance in the resection of functional area gliomas, we conducted a study. Among 120 patients with newly diagnosed functional area gliomas who underwent surgical treatment, 60 were included in each group: the integrated group with iMRI and fMRI and the conventional navigation group. Between-group comparisons were made for the extent of resection (EOR), preoperative and postoperative activities of daily living based on the Karnofsky performance status, surgery duration, and postoperative intracranial infection rate. Compared to the conventional navigation group, the integrated navigation group with iMRI and fMRI exhibited significant improvements in tumor resection (complete resection rate: 85.0% vs. 60.0%, P = 0.006) and postoperative life self-care ability scores (Karnofsky score) (median ± interquartile range: 90 ± 25 vs. 80 ± 30, P = 0.013). Additionally, although the integrated navigation group with iMRI and fMRI required significantly longer surgeries than the conventional navigation group (mean ± standard deviation: 411.42 ± 126.4 min vs. 295.97 ± 96.48 min, P<0.0001), there was no significant between-group difference in the overall incidence of postoperative intracranial infection (16.7% vs. 18.3%, P = 0.624). The combination of 3.0 T iMRI with multimodal fMRI guidance enables effective tumor resection with minimal neurological damage.

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术中 3.0 T 磁共振成像与功能磁共振成像导航相结合引导功能区胶质瘤切除术的临床评估

为了评估 3.0 T 术中磁共振成像（iMRI）结合多模态功能磁共振成像（fMRI）引导切除功能区胶质瘤的临床实用性和安全性，我们进行了一项研究。在 120 名接受手术治疗的新确诊功能区胶质瘤患者中，每组 60 人：iMRI 和 fMRI 综合组和传统导航组。组间比较了切除范围（EOR）、基于卡诺夫斯基表现状态的术前和术后日常生活活动能力、手术时间和术后颅内感染率。与传统导航组相比，采用 iMRI 和 fMRI 的综合导航组在肿瘤切除率（完全切除率：85.0% 对 60.0%，P = 0.006）和术后生活自理能力评分（Karnofsky 评分）（中位数±四分位数范围：90±25 对 80±30，P = 0.013）方面均有显著改善。此外，虽然使用 iMRI 和 fMRI 的综合导航组所需的手术时间明显长于传统导航组（平均值±标准差：411.42±126），但这并不意味着综合导航组的手术时间比传统导航组长：411.42 ± 126.4 分钟 vs. 295.97 ± 96.48 分钟，P<0.0001），但术后颅内感染的总发生率在组间无明显差异（16.7% vs. 18.3%，P = 0.624）。将 3.0 T iMRI 与多模态 fMRI 引导相结合，可有效切除肿瘤，同时将神经损伤降至最低。

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