Development of a Fluorescein Operative Microscope for use During Malignant Glioma Surgery: A Technical Note and Preliminary Report

摘要: BACKGROUND Fluorescein has been used in the field of neurosurgery; however, fluorescein enhancement or contrast proved to be inadequate because a lack appropriate light sources filters. A new operative microscope system, which itself is equipped with excitation and barrier filters, application this system surgery for malignant glioma are reported. METHODS BP 450-490, glass interference filter as source optical Kodak Wratten No. 12 were incorporated microscope. switching apparatus was devised so that filters could inserted instantly when fluorescence observed. Ten cases location enhanced by computed tomography (CT) magnetic resonance imaging (MRI) selected study. After incision dura mater, 8 mg/Kg body weight Na injected intravenously. Tumor removal begun some 20 min after injection aid newly developed system. RESULTS Fluorescence remarkable used. It enabled surgical maneuvering while viewing fluorescent image objects. The boundaries between tumor areas CT MRI surrounding brain clearly distinguished image; totally removed, except deep lesions, without any neurological deterioration. When relatively hard, area aspirated cavitron ultrasonic aspirator; result, removed en bloc; otherwise, piece piece. CONCLUSIONS This provides adequate useful observing intravenously during an operation. Though long-term follow-up such needed, conditions our patients immediately satisfactory. These results suggest highly effective glioma.