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目的探讨术中超声联合神经导航在显微神经外科切除颅内海绵状血管瘤中的作用和价值。方法选择10例颅内深部海绵状血管瘤患者,利用MRI介导的神经导航系统引导开颅,采用术中超声实时监测,确定海绵状血管瘤的部位、边界、周围毗邻重要结构关系,采取合适的入路,应用显微神经外科技术切除,利用术中超声判断病变切除的程度和范围,随访患者术后情况。结果所有病灶均在神经导航引导下开颅,神经导航术前精确度100%,骨窗暴露满意;术中超声能纠正术前神经导航定位的漂移;在其引导下10例均获得全切;术后1例轻度运动性失语,无感染,无死亡。结论术中超声联合神经导航辅助显微神经外科手术切除深部海绵状血管瘤能提高定位的准确性、减少手术副损伤、提高全切率,是一种安全有效的方法。
Objective To investigate the role and value of intraoperative ultrasound combined with neuronavigation in the removal of intracranial cavernous hemangiomas by microsurgical neurosurgery. Methods Ten patients with intracranial deep cavernous hemangioma were enrolled. MRI was used to guide the craniotomy. Real-time intraoperative ultrasound was used to determine the location and boundary of cavernous hemangioma. Adjacent to the important structural relationship, Of the way, the application of microsurgical neurosurgical resection, the use of intraoperative ultrasound to determine the extent and extent of lesion resection, follow-up of patients after surgery. Results All the lesions were craniotomized under the guidance of neuro-navigation. The preoperative accuracy of neuro-navigation was 100% and the bone window was exposed satisfactorily. Intraoperative ultrasound could correct the drift of preoperative neuro-navigational positioning. One case of postoperative mild motor aphasia, no infection, no death. Conclusion Intraoperative ultrasound combined with neuronavigation assisted microsurgical neurosurgical resection of deep cavernous hemangiomas can improve the accuracy of positioning, reduce surgical side injury and improve the rate of cut, is a safe and effective method.