Early experience with 3-T magnetic resonance tractography in the surgery of cerebral arteriovenous malformations in and around the visual pathway
Early experience with 3-T magnetic resonance tractography in the surgery of cerebral arteriovenous malformations in and around the visual pathway
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DOI：
10.1227/01.neu.0000195017.82776.90
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发表时间：
2006-02-01
期刊：
影响因子：
4.8
通讯作者：
Hashimoto, N
中科院分区：
文献类型：
--
作者：
Kikuta, K;Takagi, Y;Hashimoto, N
目的：探讨磁共振（MR）神经束造影在视神经通路内及周围脑动静脉畸形（AVM）手术中的作用。方法：在1978年至2005年间我院收治的322例脑动静脉畸形患者中，对29例患者进行了磁共振神经束造影研究。这些患者中有10人在视觉通路内或周围有动静脉畸形，他们被纳入了这项研究。男性2名，女性8名，年龄15 ~ 64岁（平均年龄34.5±14.8岁）。所有患者均行3-T视光束造影（OR）和神经眼科评估。10例患者中有4例手术切除了动静脉畸形。大多数患者在术后1个月进行了术后3-T MR研究和神经眼科评估。结果：术前束状造影显示从内侧颞区到初级视觉皮层有连续的OR束的患者有轻微或没有视野丧失，而束状造影未显示连续OR束的患者有明显的视力丧失。术后研究中示束OR的患者术后视野丧失没有恶化，而示束OR未示束的患者表现出明显的视野丧失。结论：考虑到该方法的一些局限性，该技术可用于确认偏道的完整性和定位以及评估手术风险，特别是对于视觉通路内和周围的非出血性avm。
OBJECTIVE: To evaluate of the role of magnetic resonance (MR) tractography on the optic radiation with a 3-T MR unit in the surgery of cerebral arteriovenous malformation (AVM) in and around the visual pathway.METHODS: Of the 322 patients with cerebral AVMs admitted to our clinic between 1978 and 2005, a study of MR tractography was made on 29 patients. Ten of those patients had AVMs in and around the visual pathway and were included in this study. There were two men and eight women ranging in age from 15 to 64 years (mean age, 34.5 +/- 14.8 yr). All of the patients underwent 3-T tractography of optic radiation (OR) and neuro-ophthalmologic evaluation. Four of the 10 patients underwent surgical resection of the AVM. A postoperative 3-T MR study and a neuro-ophthalmologic evaluation was performed 1 month after surgery in most patients.RESULTS: The preoperative patients for whom tractography demonstrated a continuous bundle of OR from the medial temporal region to the primary visual cortex had minimal or no visual field loss, whereas the patients for whom the tractography did not show a continuous bundle of OR had significant visual loss. The patients for whom tractography in the postoperative study demonstrated a bundle of OR experienced no postoperative deterioration of the visual field loss, whereas the patients for whom tractography did not demonstrate a bundle of OR exhibited significant visual field loss.CONCLUSION: This technique is thought to be useful in confirming the integrity of and localizing deviated tract and in evaluating the surgical risk, especially for nonhemorrhagic AVMs in and around the visual pathways, taking some limitations of this method into consideration.