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基于 3.0T 磁共振注册的神经导航系统在无框架

立体定向颅内病变活检术中的应用研究

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黄啸元，乌拉别克·毛力提，阿布都克尤木·吉力力，王继超 ，杨小朋 查看原文

【摘要】 背景 随着现代神经影像学和神经导航技术的进步，无框架脑活检技术在当今越来越普及。目的 探
讨基于 3.0T 磁共振注册的神经导航系统在无框架立体定向颅内病变活检术中的应用。方法 选取 2018 年 3 月至 2021
年 6 月在新疆维吾尔自治区人民医院神经外科住院的 27 例颅内病变患者为研究对象，患者术前行 3.0T 磁共振扫描，
注册并应用美敦力 Stealth S7 神经导航系统行无框架立体定向颅内病变活检术。回顾性分析患者的术前资料、术后并发
症、病理诊断率等资料。结果 对 27 例患者进行了无框架立体定向颅内病变活检术，其中间变性星形细胞瘤占 33.3%
（9/27），大 B 细胞淋巴瘤占 18.5%（5/27）。26 例（96.3%）患者经立体定向活检术明确病理诊断，术中穿刺道出血
发生率为 7.4%（2/27）；术后并发症发生率为 18.5%（5/27），术后颅内出血发生率为 14.8%（4/27），术后肺部感染
发生率为 3.7%（1/27）；无死亡病例。结论 基于 3.0T 磁共振注册的神经导航系统下无框架立体定向颅内病变活检术
是一种安全有效的方法，具有较高的诊断率。
【关键词】 脑疾病；神经导航；磁共振成像；影像引导活检；神经胶质瘤；星形细胞瘤；手术后并发症
【中图分类号】 R 742 R 651 【文献标识码】 B DOI：10.12114/j.issn.1007-9572.2022.0318
黄啸元，乌拉别克·毛力提，阿布都克尤木·吉力力，等 . 基于 3.0T 磁共振注册的神经导航系统在无框架立体定
向颅内病变活检术中的应用研究［J］. 中国全科医学，2022，25（29）：3686-3690，3697.［www.chinagp.net］
HUANG X Y，WULABIEKE M，ABUDUKEYOUMU J，et al. Application of a neuronavigation system utilizing 3.0T
magnetic resonance imaging in frameless stereotactic brain biopsies［J］. Chinese General Practice，2022，25（29）：3686-
3690，3697.

Application of a Neuronavigation System Utilizing 3.0T Magnetic Resonance Imaging in Frameless Stereotactic Brain
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Biopsies HUANG Xiaoyuan，WULABIEKE·Maoliti，ABUDUKEYOUMU·Jilili，WANG Jichao ，YANG Xiaopeng
Department of Neurosurgery，People's Hospital of Xinjiang Uygur Autonomous Region，Urumqi 830001，China
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Corresponding author：WANG Jichao，Chief physician；E-mail：xjsjwk@sina.com
【Abstract】 Background With the advancement of modern neuroimaging and neuronavigation techniques，frameless
intracranial biopsy techniques have been increasingly used. Objective To assess the application value of a neuronavigation
system using 3.0T magnetic resonance imaging（MRI） in frameless stereotactic brain biopsies. Methods Twenty-seven
patients with intracranial lesions were recruited in the Department of Neurosurgery，People's Hospital of Xinjiang Uygur
Autonomous Region from March 2018 to June 2021. All of them underwent brain MRI at 3.0T，then registered for using the
Medtronic Stealth Station S7 neuronavigation system to implement frameless stereotactic brain biopsies. Pre-biopsy data，post-
biopsy complications and pathological diagnosis rate were reviewed retrospectively. Results In all，27 biopsies were performed
in these 27 cases，among which anaplastic astrocytoma and large B-cell lymphoma accounted for 33.3%（9/27），and 18.5%
（5/27），respectively. Twenty-six cases obtained a definite diagnosis by frameless stereotactic brain biopsies，with a rate of
pathological diagnosis of 96.3%. During the brain biopsy，puncture tract bleeding occurred in two cases（7.4%），and one of
them was confirmed with serious bleeding by post-biopsy brain CT. Five cases had post-biopsy complications（18.5%），four
of them had intracranial hemorrhage（14.8%），and the other one case had pulmonary infection（3.7%）. No death occurred in
the biopsy. Conclusion This kind of frameless stereotactic brain biopsy is safe and effective with a high diagnostic rate.
【Key words】 Brain diseases；Neuronavigation；Magnetic resonance imaging；Image-guided biopsy；Glioma；
Astrocytoma；Postoperative complications

基金项目：国家自然科学基金资助项目（82060316）
830001 新疆维吾尔自治区乌鲁木齐市，新疆维吾尔自治区人民医院神经外科
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通信作者：王继超，主任医师；E-mail：xjsjwk@sina.com
本文数字出版日期：2022-07-14