Cargando…
Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes
Hypothalamic hamartoma (HH) is a rare lesion consisting of normal neurons and neuroglia arranged in an abnormal pattern which usually causes gelastic seizures (GS). Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has been developed as a minimally invasive approach to treat HH...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9658093/ https://www.ncbi.nlm.nih.gov/pubmed/36362807 http://dx.doi.org/10.3390/jcm11216579 |
_version_ | 1784829865101361152 |
---|---|
author | Yao, Yuan Wang, Xiu Hu, Wenhan Zhang, Chao Sang, Lin Zheng, Zhong Mo, Jiajie Liu, Chang Qiu, Jiaji Shao, Xiaoqiu Zhang, Jianguo Zhang, Kai |
author_facet | Yao, Yuan Wang, Xiu Hu, Wenhan Zhang, Chao Sang, Lin Zheng, Zhong Mo, Jiajie Liu, Chang Qiu, Jiaji Shao, Xiaoqiu Zhang, Jianguo Zhang, Kai |
author_sort | Yao, Yuan |
collection | PubMed |
description | Hypothalamic hamartoma (HH) is a rare lesion consisting of normal neurons and neuroglia arranged in an abnormal pattern which usually causes gelastic seizures (GS). Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has been developed as a minimally invasive approach to treat HH and gradually become a first-line treatment. In total, this study enrolled 47 consecutive HH patients that underwent one round of ablation. Patients were followed for at least one year. Patients’ medical records and surgical information were carefully reviewed, and univariate analyses were performed. Of the treated patients, 72.3% remained GS-free in this study, with an overall Engel class I rate of 68.1%. Long-term postoperative complications occurred in six patients. Factors associated with GS prognosis included Delalande classification (p = 0.033), HH volume (p = 0.01), and the ablation rate of the HH body (p = 0.035). The disconnection rate was 0.73 ± 0.14 in the Engel class Ia group as compared to 0.62 ± 0.13 in the Engel Ib–Engel IV group (p = 0.046). MRgLITT represents a safe and effective surgical procedure. Patients with larger or Delalande type IV HH may require multiple rounds of ablation. In addition to assessing the degree of disconnection, ablation volume should also be carefully considered for patients undergoing this procedure. |
format | Online Article Text |
id | pubmed-9658093 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96580932022-11-15 Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes Yao, Yuan Wang, Xiu Hu, Wenhan Zhang, Chao Sang, Lin Zheng, Zhong Mo, Jiajie Liu, Chang Qiu, Jiaji Shao, Xiaoqiu Zhang, Jianguo Zhang, Kai J Clin Med Article Hypothalamic hamartoma (HH) is a rare lesion consisting of normal neurons and neuroglia arranged in an abnormal pattern which usually causes gelastic seizures (GS). Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has been developed as a minimally invasive approach to treat HH and gradually become a first-line treatment. In total, this study enrolled 47 consecutive HH patients that underwent one round of ablation. Patients were followed for at least one year. Patients’ medical records and surgical information were carefully reviewed, and univariate analyses were performed. Of the treated patients, 72.3% remained GS-free in this study, with an overall Engel class I rate of 68.1%. Long-term postoperative complications occurred in six patients. Factors associated with GS prognosis included Delalande classification (p = 0.033), HH volume (p = 0.01), and the ablation rate of the HH body (p = 0.035). The disconnection rate was 0.73 ± 0.14 in the Engel class Ia group as compared to 0.62 ± 0.13 in the Engel Ib–Engel IV group (p = 0.046). MRgLITT represents a safe and effective surgical procedure. Patients with larger or Delalande type IV HH may require multiple rounds of ablation. In addition to assessing the degree of disconnection, ablation volume should also be carefully considered for patients undergoing this procedure. MDPI 2022-11-06 /pmc/articles/PMC9658093/ /pubmed/36362807 http://dx.doi.org/10.3390/jcm11216579 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Yao, Yuan Wang, Xiu Hu, Wenhan Zhang, Chao Sang, Lin Zheng, Zhong Mo, Jiajie Liu, Chang Qiu, Jiaji Shao, Xiaoqiu Zhang, Jianguo Zhang, Kai Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes |
title | Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes |
title_full | Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes |
title_fullStr | Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes |
title_full_unstemmed | Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes |
title_short | Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes |
title_sort | magnetic resonance-guided laser interstitial thermal therapy for hypothalamic hamartoma: surgical approach and treatment outcomes |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9658093/ https://www.ncbi.nlm.nih.gov/pubmed/36362807 http://dx.doi.org/10.3390/jcm11216579 |
work_keys_str_mv | AT yaoyuan magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT wangxiu magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT huwenhan magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT zhangchao magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT sanglin magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT zhengzhong magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT mojiajie magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT liuchang magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT qiujiaji magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT shaoxiaoqiu magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT zhangjianguo magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT zhangkai magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes |