多模態影像聯合多模態監測輔助切除功能區腦膠質瘤的療效分析

【中圖分類號】 R739.41 【文獻標志碼】A 【文章編號】 1672-7770（2025）03-0284-07

Abstract： ObjectiveTo investigate the application value multimodal imaging combined with multimodal moniring techniques in assisting the surgical resection gliomas situated in eloquent brain areas. MethodsThe clinical data 112 patients with glioma in eloquent areas admitted from January 2O18 December 2O23 were analyzed retrospectively. All were divided in the multimodal group（69 cases） and the microsurgery group （43 cases）based on the utilization preoperative multimodal imaging and intraoperative multimodal moniring. Comparative evaluations included gross tal resection rate，complication incidence， operative time， intraoperative blood loss，hospitalization duration， posperative neurological function，tumor recurrence，and survival outcomes.ResultsThe multimodal group exhibited a significantly higher gross tal resection rate compared the microsurgery group（ 76.8% Us 58.1% ， （204號 P=0.037 ），alongside markedly reduced complication rates， intraoperative blood loss，and hospital stay duration（all Plt;0.05 ）.Additionally，posperative Karnsky performance status scores were significantly improved in the multimodal group（ Plt;0.05） . The multimodal also demonstrated lower posperative recurrence rates （ Plt;0.05） ）and an extended median survival t ime（χ²=4.454，P= 0.035）. Despite the longer operative duration observed in the multimodal group（ Plt;0.05， ，no significant diffrence was found in posperative pulmonary infection rates between the two groups （ Pgt;0.05 ）.ConclusionsThe individualized combined application preoperative multimodal imaging and intraoperative multimodal moniring strategies enhances tumor resection rates ， mitigates neurological injury，improves posperative functional outcomes，and extends survival in patients with gliomas located in eloquent brain areas.

Key words： glioma in eloquent areas ; multimodal image ;intraoperative moniring technique; surgical treatment

起源于神經膠質細胞的腦膠質瘤是最常見的原發性中樞神經系統腫瘤，具有發病率、復發率及死亡率\"三高\"的臨床特點[]。在臨床治療方面，手術切除仍是現階段的核心治療手段，同時結合放療、化療、免疫治療與分子靶向治療形成的多學科聯合治療方案，眾多研究已證實，實現最大限度切除腫瘤能夠有效改善患者預后，使患者的無進展生存期和總體生存期獲得顯著延長[2-3]。當對鄰近或累及關鍵腦功能區的浸潤性腫瘤進行手術切除時，由于存在較高的神經功能損傷風險，如何在最大化病灶清除與最小化神經功能損害之間取得精準平衡是改善患者預后的關鍵點及難點[4]。近年來的醫學技術進步顯著提高了現代外科手術的精準度，通過術前采用多模態影像融合技術輔助手術規劃，術中整合神經導航系統、熒光顯微成像、超聲引導等多種先進技術，為實現最大安全范圍切除腫瘤病灶提供了可能[5]。本研究納入2018年1月—2023年12月廣元市中心醫院收治的112例功能區腦膠質瘤患者，旨在分析個體化聯合應用術前多模態影像及術中多模態監測技術在腦功能區膠質瘤手術治療中的應用價值。現報告如下。

1資料與方法

1.1一般資料共納入112例首次接受手術治療的功能區腦膠質瘤患者，其中個體化聯合使用術前多模態影像及術中監測技術（術中超聲、神經導航、電生理監測、術中熒光顯像及喚醒麻……