ABSTRACT
Objective To evaluate the application value of arcuate fasciculus diffusion tensor imaging (DTI) combined with neuronavigation in epilepsy surgery. Methods A retrospective analysis of 24 patients with refractory epilepsy, admitted to our hospital from March 2011 to March 2014, was performed; the epileptic foci of these patients were adjacent to the language functional areas conformed by imaging before operation. Surgical resection was performed with the help of arcuate fasciculus of DTI, diffusion tensor fiber tracking (DT-FT) combined with neuronavigation. The surgical efficacy and language function of the patients were evaluated by Engel classification and Verbal Behavior Assessment Scale (VerBAS) at postoperative follow-up. Results During the follow-up from 12 to 47 months, according to Engel classification, in 7 patients with foci adjacent to Broca area, Engel grade I was achieved in 3, Engel grade II in 3 and Engel grade Ⅲ in one; and in 17 patients with foci adjacent to Wernicke area, seizure control was as follows: Engel grade I was noted in 13, Engel grade II in 2 and Engel grade III in 2. No perpetual language dysfunction after operation was noted in all the patients. Conclusion Arcuate fasciculus DTI combined with intraoperative neuronavigation has very high application value in the epilepsy surgery.
ABSTRACT
Objective To evaluate the clinical effect of functional neuronavigation combined with intra-operative magnetic resonance imaging (iMRI) in resection of symptomatic occipital lobe epilepsy.Methods Sixteen patients with symptomatic occipital lobe epilepsy,admitted to our hospital from January 2011 to April 2012,were involved in present study.All patients underwent surgical operation assisted by functional neuronavigation.Before the operation,MRI scanning,imaging fusing,scope of lesion excision describing,and operative approach designing were performed successively.Three-D reconstructed navigation plan was integrated into neuronavigation system and used by combining with functional neuronavigation under microscope during the surgical procedure.And,the iMRI was performed in five of them; the operative plan of the residuary lesion was redesigned accordingly.After the operation,the regular clinical and iconography follow-up were in progress.Results The functional neuronavigation was successfully completed.The lesions,posterior central gyrus and pyramidal tracts were projected into operation microscope.The lesions were precisely excised,and the posterior central gyrus and pyramidal tracts were protected effectively.The last iMRI indicated that the range of resection was coincided with the pro-operative plan.During the follow-up of 12-24 months,11 patients were found to be completely seizure-free or with only aura (Engel I),and 5 patients had only rare seizure (Engel Ⅱ,fewer than three seizures per year).Nine patients appeared visual field defect without hemiparalysis or hemianesthesia.Conclusion Functional neuronavigation combined with iMRI is a safe and reliable technique for perfect resection of symptomatic occipital lobe epilepsy and reduction of normal brain functions by precisely locating lesions and important functional structures.
ABSTRACT
Objective To improve the ventilation mode for respiratory failure based on the self-made respirator. Methods For the conscious COPD patients with type II respiratory failure, nasal mask and NEEP ventilation mode were used. Patients breathe in air through the mouth and breathe out through the noses. There is no need of manual control tube to control the negative pressure in the nasal mask. For the non-typical type I respiratory failure, exhaled gas comes out from the one-way channel in the front of the mask, while oxygen for the next breathes is brought into the ball through the tube under it. Results The COPD patients breathe more freely and smoothly without disturb of the manual control tube. On the non-typical type I respiratory failure, FiO2 is much higher and without breath in CO2. Conclusion The new ventilation mode can provide a great range of FiO2 and get ride of redundant CO2. It's beneficial to the recovery of patients.