Neuronavigation combined with intraoperative ultrasound in the resection of gliomas with epilepsy_Journal of Epilepsy

Authors：

 GUO Tao ¹ , GUO Fei ² , LIU Qianwei ¹

1. Department of Neurology, Hebei Provincial People's Hospital, Shijiazhuang 050051, China;
2. Department of Rehabilitation, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China;

Corresponding author：

GUO Tao, Email: 8888guotao@sina.com

Keywords：

Neuronavigation; Intraoperative ultrasound; Glioma; Epilepsy; Operation

DOI：

10.7507/2096-0247.20190031

Video：

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Objective To investigate the clinical value of neuronavigation combined with intraoperative ultrasound in the resection of glioma with epilepsy.Methods To review and analyze the clinical data of 47 glioma patients with epilepsy treated by intraoperative ultrasound-assisted neuronavigation during the period from June 30, 2012 to June 30, 2014, and to compare and analyze the extent of gliom resection and the control of epilepsy before and after surgery.Results All the patients had no hematoma, infection or hemiplegia. MRI was reviewed 48 hours after surgery and MRI showed complete resection in 34 cases and subtotal resection in 13 cases. One year after the operation, the seizure control was evaluated. Engel’s class I, 17 cases, Engel’s class II, 20 cases, Engel’s class III, 10 cases. When the nerve function is protected, the tumor is removed and the epileptic seizure is controlled, and the clinical effect is remarkable.Conclusions Neuronavigation is helpful to locate the lesion and brain functional area and design the surgical approach before surgery, and to guide the location and boundary of the lesion and functional area during surgery. Intraoperative ultrasound has many advantages such as noninvasive, repeatable and real-time examination. Neuronavigation combined with intraoperative ultrasound can achieve maximum resection of gliomas and epileptogenic foci and reduce the incidence of postoperative neurological dysfunction in patients.

Citation： GUO Tao, GUO Fei, LIU Qianwei. Neuronavigation combined with intraoperative ultrasound in the resection of gliomas with epilepsy. Journal of Epilepsy, 2019, 5(3): 176-181. doi: 10.7507/2096-0247.20190031 Copy

1.	Coenen VA, Krings T, Weidemann J, et al. Sequential visualization of brain and fiber tract deformation during intracranial surgery with three-dimensional ultrasound: an approach to evaluate the effect of brain shift. Neurosurgery, 2005, 56(Suppl 1): 133-141; discussion: 133-141.
2.	Renner C, Lindner D, Schneider JP, et al. Evaluation of intra-operative ultrasound imaging in brain tumor resection: a prospective study. Neurol Res, 2005, 27(4): 351-357.
3.	Yamada H, Fujimatsu T, Suzuki H, et al. Surgical excision of left atrial myxoma shortly after cerebral embolism;report of a case. Kyobu Geka, 2015, 68(3): 221-223.
4.	Unsgaard G, Ommedal S, Muller T, et al. Neuronavigation by intraoperative three-dimensional ultrasound: initial experience during brain tumor resection. Neurosurgery, 2002, 50(4): 804-812; discussion: 812.
5.	Coburger J, Merkel A, Scherer M, et al. Low-grade glioma surgery in intraoperative magnetic resonance imaging I: results of a multicenter retrospective assessment of the german study group for intraoperative magnetic resonance imaging. Neuro Surgery, 2016, 78(6): 775-786.
6.	Kanno S, Tomizawa A, Hiura T, et al. Inhibitory effects of naringenin on tumor growth in human cancer cell lines and sarcoma S-180-implanted mice. Biol Pharm Bull, 2005, 28(3): 527-530.
7.	Woydt M, Perez J, Meixensberger J, et al. Intra-operative colour-duplex-sonography in the surgical management of cerebral AV-malformations. Acta Neurochir (Wien), 1998, 140(7): 689-698.
8.	Ba JL, Jandial R, Nesbit A, et al. Current and emerging treatments for brain metastases. Oncology (Williston Park), 2015, 29(4): 250-257.
9.	葛亚娟, 杨磊, 高军喜, 等. 术中超声造影定量分析在诊断不同级别胶质瘤瘤体及瘤周水肿的临床价值. 中国超声医学杂志, 2015, 3(31): 193-196.
10.	贺焱, 何文, 杜丽娟, 等. 术中超声造影评价脑胶质瘤病理分级及瘤周水肿. 中华超声影像学杂志, 2011, 12(20): 1036-1039.
11.	王佳, 段云友, 刘禧, 等. 术中超声引导脑胶质瘤手术对患者生存时间的评价. 中华超声影像学杂志, 2013, 11(22): 941-944.
12.	郭韬, 刘倩薇, 陈尧, 等. 脑磁图联合弥散张量成像在常规磁共振成像阴性的额叶局灶性皮质发育不良术前评估中的应用价值. 中国全科医学, 2015, 18(6): 729-732.
13.	杨卓, 王新军, 杨如意. 胶质瘤相关性癫痫术后疗效及影响因素分析. 中国神经精神疾病杂志, 2017, 43(4): 220-224.
14.	郭韬, 梁传栋, 吴玉锦, 等. 脑磁图联合 DTI 对大脑半球萎缩继发癫痫患者术前功能区评估的价值. 中华神经医学杂志, 2014, 13(9): 919-924.
15.	Sommer B, Roessler K, Rampp S, et al. Magnetoencephalography-guided surgery in frontal lobe epilepsy using neuronavigation and intraoperative MR imaging. Epilepsy Res, 2016, 126: 26-36.
16.	Pellegrino G, Hedrich T, Chowdhury RA, et al. Investigation of subdural electrode displacement in invasive epilepsy surgery workup using neuronavigation and intraoperative MRI. Hum Brain Mapp, 2018, 39(1): 218-231.
17.	Kishima H, Kato A, Oshino S, et al. Navigation-assisted trans-inferotemporal cortex selective amygdalohippocampectomy for mesial temporal lobe epilepsy: preserving the temporal stem. Neurol Res, 2017, 39(3): 223-230.
18.	Sang S, Wanggou S, Wang Z, et al. Clinical long-term follow-up evaluation of functional neuronavigation in adult cerebral gliomas. World Neurosurg, 2018, 119: e262-e271.
19.	Souza VH, Matsuda RH, Peres ASC, et al. Development and characterization of the invesalius navigator software for navigated transcranial magnetic stimulation. J Neurosci Methods, 2018, 309: 109-120.
20.	Pinggera D, Kerschbaumer J, Bauer M, et al. Accuracy validation of neuronavigation comparing headholder-based system with head-mounted array-a cadaveric study. World Neurosurg, 2018, 120: e313-e317.

1. Coenen VA, Krings T, Weidemann J, et al. Sequential visualization of brain and fiber tract deformation during intracranial surgery with three-dimensional ultrasound: an approach to evaluate the effect of brain shift. Neurosurgery, 2005, 56(Suppl 1): 133-141; discussion: 133-141.
2. Renner C, Lindner D, Schneider JP, et al. Evaluation of intra-operative ultrasound imaging in brain tumor resection: a prospective study. Neurol Res, 2005, 27(4): 351-357.
3. Yamada H, Fujimatsu T, Suzuki H, et al. Surgical excision of left atrial myxoma shortly after cerebral embolism;report of a case. Kyobu Geka, 2015, 68(3): 221-223.
4. Unsgaard G, Ommedal S, Muller T, et al. Neuronavigation by intraoperative three-dimensional ultrasound: initial experience during brain tumor resection. Neurosurgery, 2002, 50(4): 804-812; discussion: 812.
5. Coburger J, Merkel A, Scherer M, et al. Low-grade glioma surgery in intraoperative magnetic resonance imaging I: results of a multicenter retrospective assessment of the german study group for intraoperative magnetic resonance imaging. Neuro Surgery, 2016, 78(6): 775-786.
6. Kanno S, Tomizawa A, Hiura T, et al. Inhibitory effects of naringenin on tumor growth in human cancer cell lines and sarcoma S-180-implanted mice. Biol Pharm Bull, 2005, 28(3): 527-530.
7. Woydt M, Perez J, Meixensberger J, et al. Intra-operative colour-duplex-sonography in the surgical management of cerebral AV-malformations. Acta Neurochir (Wien), 1998, 140(7): 689-698.
8. Ba JL, Jandial R, Nesbit A, et al. Current and emerging treatments for brain metastases. Oncology (Williston Park), 2015, 29(4): 250-257.
9. 葛亚娟, 杨磊, 高军喜, 等. 术中超声造影定量分析在诊断不同级别胶质瘤瘤体及瘤周水肿的临床价值. 中国超声医学杂志, 2015, 3(31): 193-196.
10. 贺焱, 何文, 杜丽娟, 等. 术中超声造影评价脑胶质瘤病理分级及瘤周水肿. 中华超声影像学杂志, 2011, 12(20): 1036-1039.
11. 王佳, 段云友, 刘禧, 等. 术中超声引导脑胶质瘤手术对患者生存时间的评价. 中华超声影像学杂志, 2013, 11(22): 941-944.
12. 郭韬, 刘倩薇, 陈尧, 等. 脑磁图联合弥散张量成像在常规磁共振成像阴性的额叶局灶性皮质发育不良术前评估中的应用价值. 中国全科医学, 2015, 18(6): 729-732.
13. 杨卓, 王新军, 杨如意. 胶质瘤相关性癫痫术后疗效及影响因素分析. 中国神经精神疾病杂志, 2017, 43(4): 220-224.
14. 郭韬, 梁传栋, 吴玉锦, 等. 脑磁图联合 DTI 对大脑半球萎缩继发癫痫患者术前功能区评估的价值. 中华神经医学杂志, 2014, 13(9): 919-924.
15. Sommer B, Roessler K, Rampp S, et al. Magnetoencephalography-guided surgery in frontal lobe epilepsy using neuronavigation and intraoperative MR imaging. Epilepsy Res, 2016, 126: 26-36.
16. Pellegrino G, Hedrich T, Chowdhury RA, et al. Investigation of subdural electrode displacement in invasive epilepsy surgery workup using neuronavigation and intraoperative MRI. Hum Brain Mapp, 2018, 39(1): 218-231.
17. Kishima H, Kato A, Oshino S, et al. Navigation-assisted trans-inferotemporal cortex selective amygdalohippocampectomy for mesial temporal lobe epilepsy: preserving the temporal stem. Neurol Res, 2017, 39(3): 223-230.
18. Sang S, Wanggou S, Wang Z, et al. Clinical long-term follow-up evaluation of functional neuronavigation in adult cerebral gliomas. World Neurosurg, 2018, 119: e262-e271.
19. Souza VH, Matsuda RH, Peres ASC, et al. Development and characterization of the invesalius navigator software for navigated transcranial magnetic stimulation. J Neurosci Methods, 2018, 309: 109-120.
20. Pinggera D, Kerschbaumer J, Bauer M, et al. Accuracy validation of neuronavigation comparing headholder-based system with head-mounted array-a cadaveric study. World Neurosurg, 2018, 120: e313-e317.

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