磁共振T2Flair像下扩大切除脑胶质母细胞瘤 postprint

Abstract: Objective To explore the effect of extensive resection induced by MRI T2Flair sequence on the prognosis ofglioblastoma. Methods Forty-one cases of anesthesia in patients with intracranial glioblastoma between September 2010 andJanuary 2016 in our Hospital were retrospectively analyzed. Seventeen cases were performed with MRI T2Flair sequence underextended resection of brain glioblastoma patients, 24 cases of control group with T1 enhancement were performed with theremaining resection of brain glioblastoma patients. All cases were applied with intraoperative neural navigation application inthe process of surgery combined with electrical stimulation DTI, cortex, intraoperative ultrasound, intraoperative tumorfluorescence imaging. Postoperative pathology were diagnosed with glioblastoma (GBM). The preoperative and postoperativeMRI T1 enhanced lesions and T2Flair scope were outlined by German making radiotherapy plan system. Image fusion wasconducted. The preoperative and postoperative volume were compared. T1 enhance tumor resection range and T2Flairexcision scope were definited. The patients were followed up to January 2017. The patient underwent postoperativeradiotherapy and chemotherapy. Results T1 enhanced lesions of 24 cases in Control group were excised. No patient hadneurological dysfunction after operation. Another 17 cases of T2Flair patients as extended resection, 7 cases T2Flair had aexcision of 0%~10%, 4 cases of T2Flair had a resection of 10%~25%, 6 T2Flair removed more than 25%. All patients werefollowed up to January 2017, 17 patients with GBM T2Flair excision had a median survival time of 30.45 months. In the controlgroup of 24 cases with GBM patients, median survival time was 15.37 months. Difference between two groups wassignificantly (P=0.013). T2Flair resection were divided into group of 0%~10%, 10%~25% and more than 25%. The mediansurvival time of each group was 20.16, 45, 33 months, respectively, with no significant differences . Conclusion Application ofawaken anesthesia combined with intraoperative neural navigation, electrical stimulation DTI, cortex, intraoperativeultrasound, intraoperative tumor fluorescence imaging can effectively guarantee the operation safety of the intracranial GBMpatients. It improves the T1 enhanced the rate of total resection of lesions like, promotes the maximum safe range to completethe T2Flair extended resection. T2Flair total excision of the expansion can obviously prolong the survival time of GBM patients,but not T2Flair like to remove the more the better. The difference between the survival degree of resection is not significant.