Application of neuronavigation with diffusion tensor tractography in surgery for tumor near eloquent brain area

Hu Xianchao; Zhang Shaojun; Han Yi; Zheng Xialin

doi:10.11850/j.issn.1009-122X.2017.03.007

Abstract：Objective To investigate the application value of diffusion tensor tractography (DTT) in combinaiton with neuronavigation in surgery for tumor near an eloquent brain area. Methods Clinical data of 50 patients with tumor near an eloquent brain area were analyzed retrospectively. The patients were equally divided into multi-modality fusion navigation surgery group (research group) and traditional navigation surgery group (control group) according to the different surgical methods. The differences in surgical outcomes, complications and prognosis between the two groups were compared and analyzed. Results The average operation time was 5.6 ± 1.3 h in research group and 5.4 ± 1.5 h in control group, and the difference was not statistically significant (P>0.05). The average length of hospital stay was 16.35 ± 4.29 d in research group and 19.57 ± 6.15 d in control group, and the average length of stay was shorter in research group than in control group (t=2.16, P<0.05). Total tumor resection was achieved in 19 patients (76%), subtotal resection in 4 and partial resection in 2 in research group, while total tumor resection in 12 (48%), subtotal resection in 9 and partial resection in 4 in control group, The complete resection rate was higher in research group than in control group (χ2=4.16, P<0.05). The postoperative complications occurred in 4 patients (16%) in research group and in 13 (52%) in control group, there was a statistically significant difference between the two groups (χ2=7.22, P<0.05). The mean KPS score was 89.12 ± 17.35 in research group and 73.56 ± 18.21 in control group, the difference was statistically significant (t = 3.09, P< 0.05). Conclusion Multi-modal functional neuronavigation technology with fusing DTT and other modes has a significant clinical efficacy, can improve total resection rate of tumors near the eloquent brain area and effectively reduce postoperative disability rate.