关键词: “蝴蝶状”胼胝体胶质瘤, 神经导航, 术中超声, 术中神经监测, 术中磁共振扫描, 显微手术

Abstract: Objective To report the surgical experience of “butterfly” corpus callosum glioblastoma (bGBM) resected by multimodal techniques assisted microsurgery.Methods The clinical data of 20 patients with bGBM who underwent multimodal techniques assisted microsurgery in our neurosurgery department from September 2016 to September 2022 were analyzed retrospectively.The best approach was selected according to the characteristics of preoperative imaging,and the surgical trajectory was confirmed by neuronavigation,and the ultrasound localization,nerve monitoring or magnetic resonance scanning during operation were performed.Surgical/clinical outcomes and complications were recorded.Results 12 cases achieved gross total resection and the median extent of resection was 96.7%(87.71%~100.0%).Among them,4 patients (20%) underwent intraoperative ultrasound resection,and 16 patients (80%) underwent iMRI guided resection.In which,3 patients identified residual tumors on the T1C sequence of iMRI,and continued to resect residual tumors with the assistance of neuronavigation and IONM,finally achieving total resection.New nerve dysfunction mainly includes motor disorder (1 case),memory disorder (2 cases) and language disorder (1 case),which are common in the pressure of corpus callosum,cadres and knees.At the last follow-up,the median MoCA score of survivors was 25 and the median KPS score was 80.The median disease-free survival time was 9.3 months,and the median total survival time was 11.6 months.Conclusion Multimodal techniques assisted microsurgery can achieve clinically significant resection of bGBM and obtain good clinical outcomes.

Key words: “butterfly” corpus callosum glioblastoma, neuronavigation, intraoperative ultrasound；intraoperative nerve monitoring, intraoperative magnetic resonance imaging, microsurgery