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背景:脑磁图作为一种无创性生物磁学技术,通过记录神经细胞在不同功能状态下产生的磁场变化,以磁源成像反映脑功能的即时信息。目的:应用脑磁图定位神经导航下手术治疗脑皮质运动区或附近肿瘤患者36例,评估脑磁成像在脑功能区肿瘤手术过程中的应用价值。设计:观察性实验。单位:广东省中医院神经外科。对象:选择2003-01/2006-04在广东三九脑科医院神经外科采用脑磁图定位神经导航手术治疗脑功能区肿瘤患者36例,其中男17例,女19例;年龄13～70岁。脑膜瘤19例,神经上皮肿瘤14例,转移性腺癌2例,海绵状血管瘤1例。所有患者及家属同意此治疗方案,并经医院伦理委员会批准。方法:应用采用美国4-D Neuroimaging公司的148导脑磁图系统确定运动和/或感觉皮质,采样频率为678.17 Hz,高通滤波为1.0 Hz,带宽200 Hz;脑磁图信息叠加到飞利浦公司的Philips Gyroscan Intera 1.5T超导型磁共振成像系统图像上;然后图像传递到神经导航系统,在神经导航下手术治疗脑肿瘤。于术后2～26个月通过复诊、电话的形式对患者预后情况进行随访。主要观察指标:手术效果及预后。结果:脑磁图定位显示36例脑肿瘤患者患侧功能区均发生不同程度的移位和变形,34例患者肿瘤被全切除。术后2～26个月影像学显示36例患者功能区保存良好,神经功能障碍完全恢复正常19例,无变化15例,加重2例。结论:脑磁图可无创性功能定位,为制定脑功能区保护方案提供重要的指导价值。
Background: Magnetoencephalography (BMR), as a noninvasive biomagnetism technique, records real-time information of brain function by recording changes of magnetic field generated by nerve cells under different functional states. Objective: To evaluate the value of magnetoencephalography (MRI) in neurosurgery for the treatment of 36 patients with cerebral cortical motor areas or nearby tumors. Design: Observational experiments. SETTING: Department of Neurosurgery, Guangdong Provincial Hospital of Traditional Chinese Medicine PARTICIPANTS: Thirty-six patients with brain tumor were selected from Department of Neurosurgery, Sanko Brain Hospital, Guangdong Province from January 2003 to April 2006, including 16 males and 19 females, aged 13-70 years . 19 cases of meningiomas, 14 cases of neuroepithelial tumors, 2 cases of metastatic adenocarcinoma and 1 case of cavernous hemangioma. All patients and their families agree to this treatment plan and are approved by the Hospital Ethics Committee. Methods: Motor and / or sensory cortices were identified using 148-lead magnetoencephalography system from 4-D Neuroimaging Company in USA. The sampling frequency was 678.17 Hz, the high-pass filter was 1.0 Hz and the bandwidth was 200 Hz. The magnetoencephalography information was superimposed on Philips The Philips Gyroscan Intera 1.5T superconducting magnetic resonance imaging system image is then transmitted to a neuro-navigation system for surgical treatment of brain tumors under neuronavigation. The prognosis of patients was followed up in the form of phone call after 2 to 26 months. MAIN OUTCOME MEASURES: Surgical effect and prognosis. Results: Magnetoencephalography showed that the ipsilateral functional areas of 36 patients with brain tumors had different degrees of displacement and deformation, and the tumors of 34 patients were totally resected. Imaging 2 to 26 months postoperatively showed that 36 patients had well-preserved functional areas, 19 patients had complete recovery of neurological dysfunction, 15 patients had no change and 2 patients had aggravated. Conclusion: Magnetoencephalography can be noninvasive functional positioning, providing an important guiding value for the development of brain functional area protection programs.