<博士論文>
言語野周辺グリオーマに対する摘出術における弓状束トラクトグラフィーを応用したナビゲーションシステムの有用性

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概要 Background: The utility of corticospinal tract (CST)-tractography-integrated navigation was reported for brain tumors near pyramidal tracts. However, the efficacy of arcuate fasciculus (AF)-tractograp...hy-integrated navigation is unclear. Awake craniotomy is recommended to preserve language function for glioma located near the language area, although the patients' condition can limit its application. In such cases, AF-tractography-integrated navigation may help protect neurological function. Methods: We performed a retrospective analysis of AF-tractography-integrated navigation. We evaluated 11 patients who underwent glioma surgery near the language area using AF-tractography-integrated navigation. Six patients received intraoperative awake language functional mapping,whereas five did not due to adverse preoperative or intraoperative conditions. Language function was evaluated using the Western Aphasia Battery or Standard Language Test of Aphasia both preoperatively and postoperatively (2–4 weeks and 2–3 months after surgery). Results: Extent of resection (EOR) ranged from 59.5% to 100% (mean 82.1%). Language function at 2–3 months after surgery was improved in one patient, intact in nine, and moderately disturbed in one compared with preoperative function. Among the non-awake craniotomy group, EOR ranged from 78.7% to 100% (mean 89.82%). Language function at 2–3 months after surgery was improved in one patient, intact in three, and moderately disturbed in one, in whomtumor removal very close to the AF tractwas performed following preoperative patient's intent. Conclusions: AF-tractography-integrated navigation is useful for gliomasurgery near the language area, especially for patients with unsuitable conditions for awake craniotomy.続きを見る

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pdf med3033_abstract pdf 106 KB 280 要旨
pdf med3033_summary pdf 106 KB 244 要約
pdf med3033_review pdf 152 KB 207 審査結果要旨

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登録日 2017.08.21
更新日 2018.05.14

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