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Microsurgery Resection of Intrinsic Insular Tumors via Transsylvian Surgical Approach in 12 Cases.

Wang P, Wu MC, Chen SJ, Xu XP, Yang Y, Cai J - Cancer Biol Med (2012)

Bottom Line: No death was related to the operations.Two patients had transient aphasia, 2 experienced worsened hemiplegia on opposite sides of their bodies, and 2 had mild hemiplegia and language function disturbance.By evaluating the damage of the corticospinal tract through DTI and using ultrasonography to locate the tumors during operation, microsurgery treatment removes the lesions as much as possible, protects the surrounding areas, reduces the mobility rate, and improves the postoperative quality of life.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Neuroscience Center, Nanjing Medical University, Affiliated Wuxi No.2 Hospital, Wuxi 214002, China.

ABSTRACT

Objective: To investigate the clinical characteristics, operative methods, and diffusion tensor imaging (DTI) in the resection of intrinsic insular gliomas via transsylvian approach.

Methods: From June 2008 to June 2010, 12 patients with intrinsic insular gliomas were treated via transsylvian microsurgical approach, with preoperative magnetic resonance imaging diffusion tensor imaging (MR DTI) evaluation. The data of these patients were retrospectively analyzed.

Results: All patients had astrocytoma, including 8 patients of Grades I to II, 2 patients of Grades III to IV, and 2 patients of mixed glial tumors. The insular tumors were completely removed in 9 patients, whereas they were only partially removed from 3 patients. No death was related to the operations. Two patients had transient aphasia, 2 experienced worsened hemiplegia on opposite sides of their bodies, and 2 had mild hemiplegia and language function disturbance.

Conclusions: Most of the insular gliomas are of low grade. By evaluating the damage of the corticospinal tract through DTI and using ultrasonography to locate the tumors during operation, microsurgery treatment removes the lesions as much as possible, protects the surrounding areas, reduces the mobility rate, and improves the postoperative quality of life.

No MeSH data available.


Related in: MedlinePlus

MR DTI (Figure 1-5) can assess the completeness and consistency of the white matter fibers, “depression, edema, infliction, and damage” by the tumor. The pyramidal tracts and the deep white matter were partially invaded and damaged. MRI (Figure 6-15), preoperative axial (Figure 7, 9), sagittal (Figure 6, 8), and coronal (Figure 10) T1-weighted enhancecd image showed tumor were hyper-signal with sharp border. Marked edemas surrounded the location at the medial temporal base and the insular lobe. Postoperative axial T1-weighted image (Figure 11, 12), T2-weighted image (Figure 13, 15) and T2 flair image (Figure 14) showed total tumor removal with mild edema surrounding.
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f1_15: MR DTI (Figure 1-5) can assess the completeness and consistency of the white matter fibers, “depression, edema, infliction, and damage” by the tumor. The pyramidal tracts and the deep white matter were partially invaded and damaged. MRI (Figure 6-15), preoperative axial (Figure 7, 9), sagittal (Figure 6, 8), and coronal (Figure 10) T1-weighted enhancecd image showed tumor were hyper-signal with sharp border. Marked edemas surrounded the location at the medial temporal base and the insular lobe. Postoperative axial T1-weighted image (Figure 11, 12), T2-weighted image (Figure 13, 15) and T2 flair image (Figure 14) showed total tumor removal with mild edema surrounding.

Mentions: Most of the insular tumors were hyposignal in T1-weighted images but were hyper-signal in both T2-weighted image and contrast image with sharp border. The pre-operative MR DTI clearly showed the anatomical relation between the pyramidal tracts and the lesions, how much the white matter fibers were pushed away by the lesion, and the damage in the pyramidal tracts (Figure 1 and 2). The available white matter fibers could also be located in the computer to predict further prognosis and to decide suitable surgical methods for the best resection of the tumors.


Microsurgery Resection of Intrinsic Insular Tumors via Transsylvian Surgical Approach in 12 Cases.

Wang P, Wu MC, Chen SJ, Xu XP, Yang Y, Cai J - Cancer Biol Med (2012)

MR DTI (Figure 1-5) can assess the completeness and consistency of the white matter fibers, “depression, edema, infliction, and damage” by the tumor. The pyramidal tracts and the deep white matter were partially invaded and damaged. MRI (Figure 6-15), preoperative axial (Figure 7, 9), sagittal (Figure 6, 8), and coronal (Figure 10) T1-weighted enhancecd image showed tumor were hyper-signal with sharp border. Marked edemas surrounded the location at the medial temporal base and the insular lobe. Postoperative axial T1-weighted image (Figure 11, 12), T2-weighted image (Figure 13, 15) and T2 flair image (Figure 14) showed total tumor removal with mild edema surrounding.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3643643&req=5

f1_15: MR DTI (Figure 1-5) can assess the completeness and consistency of the white matter fibers, “depression, edema, infliction, and damage” by the tumor. The pyramidal tracts and the deep white matter were partially invaded and damaged. MRI (Figure 6-15), preoperative axial (Figure 7, 9), sagittal (Figure 6, 8), and coronal (Figure 10) T1-weighted enhancecd image showed tumor were hyper-signal with sharp border. Marked edemas surrounded the location at the medial temporal base and the insular lobe. Postoperative axial T1-weighted image (Figure 11, 12), T2-weighted image (Figure 13, 15) and T2 flair image (Figure 14) showed total tumor removal with mild edema surrounding.
Mentions: Most of the insular tumors were hyposignal in T1-weighted images but were hyper-signal in both T2-weighted image and contrast image with sharp border. The pre-operative MR DTI clearly showed the anatomical relation between the pyramidal tracts and the lesions, how much the white matter fibers were pushed away by the lesion, and the damage in the pyramidal tracts (Figure 1 and 2). The available white matter fibers could also be located in the computer to predict further prognosis and to decide suitable surgical methods for the best resection of the tumors.

Bottom Line: No death was related to the operations.Two patients had transient aphasia, 2 experienced worsened hemiplegia on opposite sides of their bodies, and 2 had mild hemiplegia and language function disturbance.By evaluating the damage of the corticospinal tract through DTI and using ultrasonography to locate the tumors during operation, microsurgery treatment removes the lesions as much as possible, protects the surrounding areas, reduces the mobility rate, and improves the postoperative quality of life.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Neuroscience Center, Nanjing Medical University, Affiliated Wuxi No.2 Hospital, Wuxi 214002, China.

ABSTRACT

Objective: To investigate the clinical characteristics, operative methods, and diffusion tensor imaging (DTI) in the resection of intrinsic insular gliomas via transsylvian approach.

Methods: From June 2008 to June 2010, 12 patients with intrinsic insular gliomas were treated via transsylvian microsurgical approach, with preoperative magnetic resonance imaging diffusion tensor imaging (MR DTI) evaluation. The data of these patients were retrospectively analyzed.

Results: All patients had astrocytoma, including 8 patients of Grades I to II, 2 patients of Grades III to IV, and 2 patients of mixed glial tumors. The insular tumors were completely removed in 9 patients, whereas they were only partially removed from 3 patients. No death was related to the operations. Two patients had transient aphasia, 2 experienced worsened hemiplegia on opposite sides of their bodies, and 2 had mild hemiplegia and language function disturbance.

Conclusions: Most of the insular gliomas are of low grade. By evaluating the damage of the corticospinal tract through DTI and using ultrasonography to locate the tumors during operation, microsurgery treatment removes the lesions as much as possible, protects the surrounding areas, reduces the mobility rate, and improves the postoperative quality of life.

No MeSH data available.


Related in: MedlinePlus