Résumé
Objective:To investigate the mechanism of crossed cerebellar diaschisis(CCD) induced by supratentorial tumors and the characteristics of 18F-FDG PET/CT imaging. Methods:Eighty-six patients with supratentorial tumors who underwent 18F-FDG PET/CT whole-body imaging from January 2017 to June 2021 were retrospectively analyzed.Placement, number, size, SUVmax, CT values, relationship with basal ganglia, edema, and cerebellar asymmetry index (AI) were observed and recorded.The imaging differences between patients with CCD and patients without CCD were compared, and the correlations between SUVmax, maximum diameter and cerebellar AI were analyzed.SPSS 21.0 software was used for statistical analysis.Chi-square test, independent sample t-test and Pearson correlation analysis were used for data statistics. Results:Among the 86 patients, 14 were patients with CCD and 72 were patients without CCD.The incidence of CCD was 16.3%.There were statistically significant differences in whether the primary lesions involved the basal ganglia region between patients with CCD and patients without CCD ( χ2=7.637, P=0.006). The cerebellar AI ((0.27±0.09), (0.05±0.02), t=6.847, P=0.003)and maximum diameter of primary lesions((3.98±1.09)cm, (2.36±1.61)cm, t=2.011, P=0.040) in patients with CCD were both larger than those in patients without CCD.There was a significant positive correlation between cerebellar AI and the maximum diameter of primary lesions in patients with CCD ( r=0.375 P=0.028). Conclusion:18F-FDG PET/CT imaging can assist in the diagnosis of crossed cerebellar diaschisis.The primary lesion of supratentorial tumor involving the basal ganglia is more likely to cause crossed cerebellar diaschisis, and the size of the primary lesion is correlated with cerebellar AI.
Résumé
Objective To observe the serum concentration of S100βprotein (S100β)and neuron specific enolase (NSE)in patients undergoing supratentorial tumor resection with ulinastatin treat-ment.Methods Twenty-four patients with supratentorial tumor resection,aged 18-65 years,ASA Ⅰor Ⅱ,were randomly divided into the control group (group A,n =12)and ulinastatin group (group U,n =12).Patients in group U received ulinastatin (2 kU/kg)at the beginning of the surgery,with the continuous dose of 1 kU·kg-1 ·h-1 till the end of the operation.Group A received equivalent volume of saline solution as the vehicle control.Blood samples were taken from the artery and jugular venous bulb before induction of anesthesia (T1 ),skin incision (T2 ),1 h after dura openning (T3 ),at the closure of dura (T4 ),at the end of operation (T5 )and 24 h after operation (T6 )to analyze the concentration of S100β and NSE.The concentration of S100β and NSE were determined by ELISA. Results The concentration of serum S100β and NSE increased more significantly higher at T3-T6 in group A than group U (P <0.01).The concentration of serum S100βand NSE in group U were lower than those in group A at T3-T5 (P < 0.01 ).Conclusion Ulinastatin reduces the concentration of serum S100βand NSE during surgery,indicating it alleviates brain injury during supratentorial tumor resection.
Résumé
Objective To evaluate the effect of Astragalus injection on serum SOD and MDA in patients during supratentorial tumor resection. Methods Twenty-four patients with ASAⅠorⅡ degree, aged 20~55 years old, undergoing supratentorial tumor resection were randomized into the control group (group C) and the Astragalus group (group R), with 12 cases in each group. Patients in group R received 250 mL 0.9% sodium chloride in addition with 20 mL Astragalus injection. Patients in group C received the same amount of 0.9%sodium chloride. Blood samples were taken from jugular venous bulb before induction of anesthesia (T1), intubation (T2), open dura instantly (T3), 1 h after the dura opened (T4), 24 h after the dura opened (T5), and 48 h after the dura opened (T6). The levels of serum SOD and MDA were determined. Results The serum SOD in both group R and group C was lower at T3~6 than that at T1 , but the serum SOD in group R reduced significantly compared with group C (P < 0.05); The serum MDA in both group R and group C at T4~6 was higher than that at T1, but the serum MDA in group R increased significantly compared with group C (P <0.05). Conclusion Astragalus injection can enhance the serum SOD activity and reduce MDA output in patients during supratentorial tumor resection.
Résumé
Objective To study the value and effectiveness of surgical management and mapping in supratentorial tumoral complicated with epilepsy and to study the correlations between tumor and the epileptogenic focus.Methods The clinical data of 121 patients with supratentorial cerebral tumor but epilepsy as initial symptom were retrospectively analyzed for the incidence of pre-and postoperative epileptic seizures,including grade Ⅰ glioma in 1 5 cases and grade Ⅱ glioma in 35 cases,grade Ⅲ-Ⅳglioma in 12 cases,menigoma in 32 cases,metastases in 10 cases,cavernous angiomas in 15 cases,and ependymomas in 2 cases.Results Surgery based on CT/MRI,seizure type and EEG changes was conducted.There was no death in operation.The highest incidence was in frontal lobe and the lowest in occipital lobe.Correlations between localization of tumor and the epileptogenic focus:there were 50 cases in the same location,near or beside tumors in 28 cases,far separate apart(＞2 cm)from tumors in 25 cases,no relationship was found in 18 cases.103 patients were followed up for one to nine years.31 patients had a few seizures in the early postoperative period.Epileptic seizures were cured without anti-epilepsy drugs in 83 cases.Conclusion There are some differences between tumors'location and epileptogenic focus in supratentorial tumoral epilepsy.The location and size of epileptogenic zone should be detected before and during operation.The resection of the tumor combined with the resection of the epileptogenic zone"epilepsy surgery"can provide good results.
Résumé
objective:To discuss the characteristics and localizing significance of presurgical scale ambulatory electroencephalo-gram(AEEG)in patients with supratentorial tumor by comparison their electrocorticography(ECOG).Methods:124 subjects were collected in our hospital.All patients were monitored by the scalp AEEG before surgeries and ECOG during oprating.The interictal epileptiform discharges of ECOG were divided into five catalogs.Ⅰ:no spikes.Ⅱ:isolated spikes.Ⅲ:repetitive spike-wave pattern.Ⅳ:intermittent spikes,polyspikes waves burst.Ⅴ:continuous hyper-spikes and sharps.A,B,C,D and E were represented on the scalp AEEG which corresponded the above ECOG classification.Then AEEG and ECOG were analyzed.Re-sults:(1)The scalp AEEG was abnormal in 83.87% of all subjects before surgery.Ⅱ type and Ⅲ type on ECOG did not appear easily on the scalp AEEG(P