Clinical study on resection of brain metastases assisted by functional neuronavigation combined with intraoperative sodium fluorescein imaging
Wang Zhong
Zhang Xiaojun
Zhang Ruijian
Han Zhitong
Chen Yunzhao
Xing Dong
Wang Junqing
Yang Weiran
Zhang Zhilong
Song Yuhui
Abstract：Objective To investigate the application of functional neuronavigation combined with intraoperative sodium fluorescein imaging in the surgical resection of brain metastases.Methods The clinical data of 40 patients with brain metastases were analyzed retrospectively.Patients were divided into observation group(n=20)and control group(n=20)based on whether sodium fluorescein was used during surgery.Preoperative examinations included routine and enhanced head CT,MRI,magnetic resonance angiography(MRA),magnetic resonance venography(MRV),diffusion-weighted imaging(DWI),and diffusion tensor imaging(DTI).The preoperative imaging data were imported into the functional neuronavigation software to determine the tumor location and its spatial relationship with critical nerve fiber tracts,pyramidal tracts,and major blood vessels.Image fusion with multi-planar CT was performed to formulate the surgical navigation plan.After a preoperative sodium fluorescein allergy test,patients received an intravenous injection of a low dose of sodium fluorescein(2mg/kg).During surgery,neuronavigation was combined with sodium fluorescein imaging to observe and resect the tumor margin from normal brain tissue.Results The observation group showed significantly better outcomes in tumor resection and postoperative KPS score improvement compared to the control group,with statistically significant differences(χ²=6.144,P=0.013;χ²=4.286,P=0.038).The incidence of new postoperative neurological deficits was lower in the observation group,and the difference was statistically significant(χ²=4.800,P=0.029).There were no significant differences between the two groups in postoperative complications,operative time,and hospital stay(χ²=2.294,P=0.130;t=0.589,P=0.560;t=1.065,P=0.294).Conclusions Multimodal functional neuronavigation combined with intraoperative sodium fluorescein imaging can accurately locate brain metastases,define the boundary between tumors and normal brain tissue,tumor resection rates,and improve patients'quality of life and prognosis.
Keywords：brain neoplasmsneoplasm metastasisneuronavigationfluorescein sodium
Publication Date：2024-06-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 340-344 )