Application of multimodal image fusion in microsurgical resection of medullary gliomas

Abstract

Objective To explore the application of multimodal image fusion in improvement of resection extent and protection of neurological function among cases of medullary gliomas. Methods The clinical data of 46 patients with medullary gliomas were retrospectively analyzed who were admitted to Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University from October 2014 to August 2017. The patients were divided into conventional group (n=23) and multimodal group (n=23). The clinical efficacy of both groups were compared and analyzed. Results The differences between two groups with regard to sex, age, growing patterns, preoperative tumor volume, preoperative KPS (Karnofsky performance status) score, postoperative pathology were not statistically significant (all P>0.05). The extent of resection in multimodal group was significantly higher than that of conventional group [(86.7±26.7)% vs. (61.8±32.9)%, P=0.007]. At 1 week post operation, the rate of short-term tracheostomy or tracheal intubation in multimodal group was lower than that in conventional group (34.8% vs. 69.6%, P=0.018). The differences between two groups with regard to short-term ventilation support and gastrostomy tubes were not statistically significant (both P>0.05). The follow-up period of 46 patients lasted for 0.6-37.0 months with a mean of 12.9±11.4 months. At 3 months post operation, the difference between two groups with regard to the retention rate of long-term tracheostomy or tracheal intubation and gastrostomy tubes was not statistically significant (all P>0.05). However, the rate of long-term ventilation support in multimodal group was lower than that in conventional group (31.8% vs. 5.0%, P=0.027) at 3-month follow-up. Conclusion The technology of multimodal image fusion could improve the resection extent of medullary gliomas without aggravating the injury of neurological function, reduce postoperative retention rate of tracheotomy or tracheal intubation and promote postoperative recovery of the patient’s long-term respiratory function. Key words: Medullary; Glioma; Microsurgery; Multimodal; Treatment outcome