黄荧光染色技术联合¹H-MRS治疗脑胶质瘤的临床疗效

Clinical Efficacy of Yellow Fluorescence Staining Combined with ¹H-MRS in the Treatment of Brain Glioma

摘要: 目的：探讨氢质子磁共振波谱(¹H-MRS)联合黄荧光染色技术在脑胶质瘤手术中的作用。方法：回顾性分析2020年1月到2022年12月于安徽医科大学第一附属医院行手术切除的90例脑胶质瘤的临床资料。术前所有的病人行氢质子磁共振波谱(¹H-MRS)检查。其中32例采用¹H-MRS + 黄荧光染色技术(以下称为实验组)，58例为常规手术组。42例患者的肿瘤距离脑室小于1 cm，32例位于额部，34例位于颞部，7例位于顶部，8例位于脑室，6例位于枕部，3例位于小脑，术中均采用神经电生理监测或术中唤醒麻醉技术。比较高低级别胶质瘤1H-MRI实质区域Cho/NAA，Cho/Cr，NAA/Cr。结果：高级别胶质瘤患者和低级别胶质瘤患者肿瘤实质区域Cho/NAA，Cho/Cr，NAA/Cr差异有统计学意义(P < 0.05)，高级别胶质瘤Cho/NAA，Cho/Cr高于低级别胶质瘤，低级别胶质瘤NAA/Cr高于高级别胶质瘤；实验组和常规组全切率(54.5%和45.5%)差异有统计学意义(P < 0.001)；距离脑室 < 1 cm，实验组和常规组全切率(65.9%和41.3%)差异有统计学意义(P < 0.05)。结论：¹H-MRS联合黄荧光染色技术对于胶质瘤的治疗，可以缩短肿瘤切除时间，提高肿瘤切除程度同时减少围手术期并发症的发生。

Abstract: Objective: To investigate the role of hydrogen proton magnetic resonance spectroscopy (¹H-MRS) combined with yellow fluorescence staining in glioma surgery. Methods: The clinical data of 90 cas-es of glioma surgically removed in the First Affiliated Hospital of Anhui Medical University from January 2020 to December 2022 were retrospectively analyzed. All patients were examined by hy-drogen proton magnetic resonance spectroscopy (¹H-MRS) before operation. Among them, 32 cases were treated with ¹H-MRS + yellow fluorescence staining technique (hereinafter referred to as the experimental group), and 58 cases were treated as the conventional operation group. The tumor distance of 42 patients was less than 1 cm from the ventricle, 32 cases were located in the forehead, 34 cases were located in the temporal part, 7 cases were located in the top part, 8 cases were locat-ed in the ventricle, 6 cases were located in the occipital part, and 3 cases were located in the cere-bellum. Intraoperative neuroelectrophysiological monitoring or awake anesthesia was used in all patients. To compare Cho/NAA, Cho/Cr, NAA/Cr in 1H-MRI of high and low grade gliomas. Results: There were statistically significant differences in Cho/NAA, Cho/Cr, NAA/Cr in tumor parenchyma between high-grade glioma patients and low-grade glioma patients (P < 0.05). Cho/NAA and Cho/Cr in high-grade glioma were higher than those in low-grade glioma, and NAA/Cr in low- grade glioma was higher than those in high-grade glioma. There was significant difference between experimental group and conventional group (54.5% and 45.5%) (P < 0.001). When the distance to the ventricle was < 1 cm, the total resection rate of the experimental group and the conventional group (65.9% and 41.3%) was significantly different (P < 0.05). Conclusion: ¹H-MRS combined yellow fluorescence staining can shorten the time of tumor resection, improve the degree of tumor resection and reduce the occurrence of perioperative complications in the treatment of glioma.