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目的利用BOLD和DECS技术进行语言功能区定位,实现语言功能区保护下肿瘤的最大程度切除。方法对15例语言相关功能区脑肿瘤患者,利用血氧依赖功能磁共振(BOLD-fMRI)技术和(或)术中唤醒麻醉下皮层直接电刺激(DECS)定位技术进行脑语言功能区定位;对所获定位资料进行个体化评估,术中辅助保护语言功能区,在神经导航指引下切除肿瘤。结果 15例患者成功获取了术前BOLD语言区图像,评估后其中6例患者实现了术前BOLD和术中DECS技术联合定位语言功能区。全组病例在保护语言区条件下病变全切除10例,次全切除3例,大部分切除2例。术后语言功能明显改善6例,无变化5例,短暂性感觉性失语2例,语言功能障碍明显加重2例。结论术前BOLD-fMRI结合术中唤醒麻醉下皮层电刺激的方法可客观定位脑语言功能区,导航辅助保护语言功能区条件下切除肿瘤,在保护语言功能的同时最大化切除肿瘤组织,提高患者术后生活质量。
Objective To use BOLD and DECS techniques to locate the functional regions of the language and to achieve the maximal resection of the tumor under the protection of the language functional area. Methods Fifteen patients with functional brain tumors of linguistically related functional regions were located in brain language using the BOLD-fMRI technique and / or the DECS technique under awake anesthesia. The localization information obtained by the individual assessment, intraoperative assistance to protect the language function area, under the guidance of nerve navigation to remove the tumor. Results Fifteen patients successfully acquired preoperative BOLD language images. Six of them achieved preoperative BOLD and intraoperative DECS combined with localization of speech function. All cases in the protection of the language area under the conditions of total lesion in 10 cases, subtotal resection in 3 cases, the majority of resection in 2 cases. Postoperative language function improved significantly in 6 cases, no change in 5 cases, transient sensory aphasia in 2 cases, language dysfunction was significantly worsened in 2 cases. Conclusions The preoperative BOLD-fMRI combined with intraoperative awakening of cortical electrical stimulation can objectively locate the brain language functional areas, and help to excise the tumor by navigational aids to protect the linguistic function areas, and maximize the removal of tumor tissues while improving language function, Postoperative quality of life.