METHODS: 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.
RESULTS: 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).
CONCLUSIONS: The combination of 3.0 T iMRI with multimodal fMRI guidance enables effective tumor resection with minimal neurological damage.
方法:在120例新诊断的功能区胶质瘤患者中,每组60例:iMRI和fMRI整合组及常规导航组。对切除程度(EOR)进行组间比较,基于Karnofsky表现状态的术前和术后日常生活活动,手术持续时间,术后颅内感染率。
结果:与常规导航组相比,具有iMRI和fMRI的集成导航组在肿瘤切除方面显着改善(完全切除率:85.0%vs.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±25vs.80±30,P=0.013)。此外,尽管使用iMRI和fMRI的集成导航组比常规导航组需要更长的手术时间(平均值±标准偏差:411.42±126.4分钟vs.295.97±96.48min,P<0.0001),术后颅内感染的总发生率无显著组间差异(16.7%vs.18.3%,P=0.624)。
结论:3.0TiMRI与多模态fMRI指导相结合,可有效切除肿瘤,同时神经损伤最小。