マルヤマ タカシ   MARUYAMA Takashi
  丸山 隆志
   所属   医学部 医学科(東京女子医科大学病院)
   職種   非常勤講師
論文種別 その他
言語種別 英語
査読の有無 査読なし
表題 Usefulness of intraoperative magnetic resonance imaging for glioma surgery
掲載誌名 正式名:Acta neurochirurgica. Supplement
略  称:Acta Neurochir Suppl
ISSNコード:00651419
掲載区分国外
巻・号・頁 98,pp.67-75
著者・共著者 MURAGAKI Yoshihiro†, MARUYAMA Takashi, KAWAMATA Takakazu, YAMANE Fumitaka, NAKAMURA Ryoichi, KUBO Osami, TAKAKURA Kintomo, HORI Tomokatsu
発行年月 2006/01/01
概要 Radical resection of gliomas can increase patient's survival. There is known concern, however, that aggressive tumour removal can result in neurological morbidity. The objective of the present study was to evaluate the usefulness of low magnetic field strength (0.3 Tesla) open intraoperative magnetic resonance imaging (iMRI) for complete resection of glioma with emphasis on functional outcome.|From 2000 to 2004, 96 patients with intracranial gliomas underwent tumour resection with the use of iMRI in Tokyo Women's Medical University. There were 50 men and 46 women; mean age was 39 years. Tumour volume varied from 1.2 ml to 198 ml (median: 36.5 mL). Resection rate and postoperative neurological status were compared between control group (46 cases, operated on during the initial period after installation of iMRI), and study group (50 most recent cases, in whom surgery was done using established treatment algorithm and improved image quality).|Overall, mean resection rate was 93%, and medial residual tumour volume was 0.17 ml. Total tumour removal was achieved in 44 cases (46%). Compared to control group, resection rate in the study group was significantly higher (91%, vs. 95%; P<0.05), whereas residual tumour volume was significantly smaller (1.7 mL vs. 0.025 mL; P<0.001). Nine patients in the control group (20%) and 24 in the study group (48%) experienced temporary postoperative neurological deterioration (P<0.01), however, the rate of permanent morbidity evaluated 3 months after surgery did not differ significantly between the groups investigated (13% vs. 14%).|Use of iMRI during surgery for intracranial gliomas permits to attain aggressive tumour resection with good functional outcome. Nevertheless, surgical experience with the iMRI system, establishment of treatment algorithm, and improvement of image quality are of paramount importance for optimal results.
DOI 10.1007/978-3-211-33303-7_10
PMID 17009703