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目的探讨Brainlab立体定向手术计划系统及图像融合技术在三叉神经半月节射频热凝术+甘油注射治疗中的应用价值。方法对26例原发性三叉神经痛患者常规行MR扫描,头部安装Leksell立体定位头架后行CT扫描,将CT及MR图像输入Brainlab立体定向手术计划系统进行图像融合,直接定位半月神经节并确定穿刺路径。结果所有患者一次性穿刺成功率100%,无穿刺损伤所致并发症,术后疼痛立即消失,疗效优良率100%,术后面部感觉减退5例,均无特殊不适感。术后随访半年～1年,无继续服药患者及复发病例。结论立体定向图像融合技术能直接定位三叉神经半月节,并能对穿刺路径进行设定,结合术中电生理定位,确保能快速准确穿刺靶点,避免了穿刺的盲目性,显著提高了穿刺的准确性和治疗效果。
Objective To investigate the value of Brainlab stereotactic surgery planning system and image fusion in radiofrequency thermocoagulation of trigeminal nerve plus glycerol injection. Methods Twenty-six patients with primary trigeminal neuralgia underwent MR scan. The head was fitted with Leksell stereotactic head scaffold and CT scan. The CT and MR images were input into Brainlab stereotactic surgery planning system for image fusion and direct localization of the semilunar ganglia And determine the puncture path. Results The successful rate of all puncture was 100%. No complications resulted from puncture injury. The pain disappeared immediately after operation. The excellent and good rate was 100%. There were 5 cases of facial sensation after operation. No special discomfort was found. Follow-up six months to 1 year after surgery, no continued medication and relapse cases. Conclusion Stereotactic image fusion technique can directly locate the trigeminal nerve meniscus, and can set the puncture path, combined with intraoperative electrophysiological localization, to ensure rapid and accurate puncture target, to avoid the blindness of puncture, significantly improve the puncture Accuracy and therapeutic effect.