神经外科医师的难解之题——酌定胶质瘤手术切除的边界
Definition of the glioma resection border: a difficultchallenge for neurosurgeons

手术切除仍然是治疗脑胶质瘤的主要手段。但是由于胶质瘤呈侵润性生长，病理学边界深远，目前的影像学方法仍然不能反映其病理学边界，加之有些胶质瘤紧邻脑功能区或生长在脑功能区。因此，在每一例胶质瘤的手术切除时酌定胶质瘤手术切除的边界成了神经外科医师的难解之题。本文结合胶质瘤的病理学边界、影像学表现和脑功能组织定位技术提出酌定胶质瘤手术切除边界的三原则，即最大程度切除胶质瘤并保留患者神经功能的原则、结合影像学表现的原则和结合胶质瘤位置的原则，供业界同行讨论。
Surgical resection is still the main method for the treatment of gliomas. However, due to the infiltrativegrowth pattern of gliomas, the pathological boundary is deep and extensive into the surrounding brain tissue. The currentimaging methods could not reflect the pathological boundary. Especially for some gliomas adjacent to or even growingin the functional area of the brain, it becomes a thorny subject for neurosurgeons to decide the resection border in everycase of glioma surgery. In this paper, based on the pathological examination, imaging performance and brain functionlocalization technology, we put forward three principles of defining glioma resection border: maximum clearance ofgliomas combined with maximum preservation of neurofunction, considering imaging performance and glioma location