术中吲哚菁绿荧光显像诊断脊髓神经鞘瘤1例。

Surgical neurology international Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI:10.25259/SNI_852_2024
Jun Hashimoto, Toshinari Kawasaki, Yoshihiko Ioroi, Tamaki Kobayashi, Motohiro Takayama
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引用次数: 0

摘要

背景:延迟窗吲哚青绿(dwig)技术在脑和脊柱肿瘤的切除中是有用的。病例描述:一名41岁女性,表现为左下背部和神经根性疼痛。磁共振成像(MRI)显示髓外L3病变位于椎管腹侧,似神经鞘瘤。在L2-L4椎板切除术和L3/L4后路腰椎融合术前1小时静脉注射吲哚菁绿(剂量,0.25 mg/kg)。在手术中,利用强近红外(NIR)信号,肿瘤通过硬脑膜清晰可见。当不能再检测到近红外信号时,确认肿瘤完全切除。病理证实为神经鞘瘤。术后MRI扫描进一步证实肿瘤完全切除。结论:在一名41岁女性患者中,术中DWICG技术有助于通过硬脑膜定位L3神经鞘瘤,并加快了肿瘤的总切除。
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Utility of intraoperative fluorescence imaging with indocyanine green for diagnosing spinal schwannoma: A case report.

Background: The delayed-window indocyanine green (DWICG) technique is useful for the removal of brain and spinal tumors.

Case description: A 41-year-old female presented with lower left back and radicular pain. An magnetic resonance imaging (MRI) revealed an extramedullary L3 lesion located ventrally in the spinal canal that appeared to be a schwannoma. Intravenous indocyanine green (dose, 0.25 mg/kg) was administered 1 h before the L2-L4 laminectomy and L3/L4 posterior lumbar fusion. At surgery utilizing a strong near-infrared (NIR) signal, the tumor was clearly visualized through the dura. Complete tumor excision was confirmed when the NIR signal could no longer be detected. Pathologically, the lesion proved to be a schwannoma. A postoperative MRI scan further confirmed complete tumor excision.

Conclusion: In a 41-year-old female, the DWICG technique intraoperatively facilitated localization of a L3 schwannoma through the dura and expedited gross total tumor removal.

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