脑组织活检,三维图像引导精准度高

2015-09-25 匡远深 中国医学论坛报

中国人民解放军海军总医院神经外科与北京航空航天大学合作开发的Aero-tech立体定位手术计划系统,采用三维可视化图像引导立体定位脑干及松果体区深部病灶精准度高,经临床88例活检验证,所有病例均获得明确的病理诊断,活检阳性率为100%。 借助Aero-tech立体定位手术计划系统,研究者对88例临床影像学难以确诊的患者进行了活检分析。其中脑干病变(中脑、桥脑)56例(占64%,),包括胶质瘤

中国人民解放军海军总医院神经外科与北京航空航天大学合作开发的Aero-tech立体定位手术计划系统,采用三维可视化图像引导立体定位脑干及松果体区深部病灶精准度高,经临床88例活检验证,所有病例均获得明确的病理诊断,活检阳性率为100%。

借助Aero-tech立体定位手术计划系统,研究者对88例临床影像学难以确诊的患者进行了活检分析。其中脑干病变(中脑、桥脑)56例(占64%,),包括胶质瘤、淋巴瘤、神经变性疾病、多发性硬化和瘤样脱髓鞘病、转移瘤等;松果体区病灶32例(占36%),包括生殖细胞类肿瘤、胶质类肿瘤、松果体细胞起源肿瘤、韦尼克(Wernicke)脑病。两区域所有活检靶点选取和穿刺路径设计均在三维可视化图像计划软件辅助下完成。松果体区病变活检采取额前-经小脑幕裂孔内进入路径;中脑病变活检采用经侧脑室-丘脑后部自上而下路径;小脑中脚平面以下脑桥或桥臂的病灶采用枕下经小脑半球-桥臂穿刺路径。

结果显示,所有病例均获得明确的病理学诊断。两区域活检术直接相关死亡1例。

据课题负责人王亚明教授介绍,三维可视化图像引导的脑组织活检技术,能够建立病灶三维空间构型,辅助设计“完全走行于脑实质内”的路径,对病变以及周围重要神经血管结构进行三维容积重建,通过对容积块的叠加、拆分、验证,设计出准确的穿刺路径,精准地获得脑深部病变组织标本,提高活检阳性率,减少出血并发症。该项技术适合脑中线区、脑干区病变的诊断,特别对后期选择个性化治疗以及预后评估具有重要的指导意义。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=184959, encodeId=38c0184959ab, content=每天看推送的资讯都是国外的,难得有国内的, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xjZ9qh3bhXrJtUlmycKGfQKPuADVZQsdNAQj5IrHHlzbGsDwScictBgogYRk8KhicpgEKwTEfOHgqw/0, createdBy=bc931611963, createdName=jin321, createdTime=Tue Apr 04 00:08:56 CST 2017, time=2017-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37975, encodeId=adbc3e975ed, content=很好的文章哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Oct 07 22:02:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1277956, encodeId=46c012e7956ef, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Sun Sep 27 00:14:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1402979, encodeId=936214029e962, content=<a href='/topic/show?id=ebbde6353be' target=_blank style='color:#2F92EE;'>#精准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76353, encryptionId=ebbde6353be, topicName=精准)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83epQX9hfEIBiaPg0e9KvLYVBCSGYydH6K6OQxBh3RaOC0TYP9HYy2v0XdHib1LFnZNU5Siak0P8oh8Aqw/132, createdBy=acd92440184, createdName=shijzhiewnjhch, createdTime=Sun Sep 27 00:14:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1592041, encodeId=8c251592041cb, content=<a href='/topic/show?id=c3a68498683' target=_blank style='color:#2F92EE;'>#脑组织#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84986, encryptionId=c3a68498683, topicName=脑组织)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Sun Sep 27 00:14:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1631452, encodeId=e02b163145249, content=<a href='/topic/show?id=1f7ae770359' target=_blank style='color:#2F92EE;'>#组织活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77703, encryptionId=1f7ae770359, topicName=组织活检)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=709f21794152, createdName=xfpan19, createdTime=Sun Sep 27 00:14:00 CST 2015, time=2015-09-27, status=1, ipAttribution=)]
    2017-04-04 jin321

    每天看推送的资讯都是国外的,难得有国内的

    0

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    2015-10-07 hlycom3356

    很好的文章哦

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=184959, encodeId=38c0184959ab, content=每天看推送的资讯都是国外的,难得有国内的, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xjZ9qh3bhXrJtUlmycKGfQKPuADVZQsdNAQj5IrHHlzbGsDwScictBgogYRk8KhicpgEKwTEfOHgqw/0, createdBy=bc931611963, createdName=jin321, createdTime=Tue Apr 04 00:08:56 CST 2017, time=2017-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37975, encodeId=adbc3e975ed, content=很好的文章哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Oct 07 22:02:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1277956, encodeId=46c012e7956ef, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Sun Sep 27 00:14:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1402979, encodeId=936214029e962, content=<a href='/topic/show?id=ebbde6353be' target=_blank style='color:#2F92EE;'>#精准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76353, encryptionId=ebbde6353be, topicName=精准)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83epQX9hfEIBiaPg0e9KvLYVBCSGYydH6K6OQxBh3RaOC0TYP9HYy2v0XdHib1LFnZNU5Siak0P8oh8Aqw/132, createdBy=acd92440184, createdName=shijzhiewnjhch, createdTime=Sun Sep 27 00:14:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1592041, encodeId=8c251592041cb, content=<a href='/topic/show?id=c3a68498683' target=_blank style='color:#2F92EE;'>#脑组织#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84986, encryptionId=c3a68498683, topicName=脑组织)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Sun Sep 27 00:14:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1631452, encodeId=e02b163145249, content=<a href='/topic/show?id=1f7ae770359' target=_blank style='color:#2F92EE;'>#组织活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77703, encryptionId=1f7ae770359, topicName=组织活检)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=709f21794152, createdName=xfpan19, createdTime=Sun Sep 27 00:14:00 CST 2015, time=2015-09-27, status=1, ipAttribution=)]
    2015-09-27 smlt2008
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  6. [GetPortalCommentsPageByObjectIdResponse(id=184959, encodeId=38c0184959ab, content=每天看推送的资讯都是国外的,难得有国内的, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xjZ9qh3bhXrJtUlmycKGfQKPuADVZQsdNAQj5IrHHlzbGsDwScictBgogYRk8KhicpgEKwTEfOHgqw/0, createdBy=bc931611963, createdName=jin321, createdTime=Tue Apr 04 00:08:56 CST 2017, time=2017-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37975, encodeId=adbc3e975ed, content=很好的文章哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Oct 07 22:02:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1277956, encodeId=46c012e7956ef, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Sun Sep 27 00:14:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1402979, encodeId=936214029e962, content=<a href='/topic/show?id=ebbde6353be' target=_blank style='color:#2F92EE;'>#精准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76353, encryptionId=ebbde6353be, topicName=精准)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83epQX9hfEIBiaPg0e9KvLYVBCSGYydH6K6OQxBh3RaOC0TYP9HYy2v0XdHib1LFnZNU5Siak0P8oh8Aqw/132, createdBy=acd92440184, createdName=shijzhiewnjhch, createdTime=Sun Sep 27 00:14:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1592041, encodeId=8c251592041cb, content=<a href='/topic/show?id=c3a68498683' target=_blank style='color:#2F92EE;'>#脑组织#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84986, encryptionId=c3a68498683, topicName=脑组织)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Sun Sep 27 00:14:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1631452, encodeId=e02b163145249, content=<a href='/topic/show?id=1f7ae770359' target=_blank style='color:#2F92EE;'>#组织活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77703, encryptionId=1f7ae770359, topicName=组织活检)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=709f21794152, createdName=xfpan19, createdTime=Sun Sep 27 00:14:00 CST 2015, time=2015-09-27, status=1, ipAttribution=)]