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・インドシアニングリーン(ICG)は脳脊髄腫瘍内に貯留し,視覚化される.現時点での最適なプロトコルは,観察1時間前に顕微鏡は1.5 mg/kg,内視鏡は0.5 mg/kgの投与とされる.
・メカニズムは,Gd造影剤が血液脳関門から漏れ出す機構と同様で,permeabilityが寄与する.
・ICG術中蛍光造影はGd造影剤で造影される脳脊髄腫瘍で有用である.
This article discusses the development and clinical application of intraoperative fluorescence-guided diagnosis for brain and spinal tumors using indocyanine green (ICG). The Delayed Window ICG (DWIG) technique enhances tumor visualization during surgery, improving resection accuracy and prognosis. By exploiting ICG's selective tumor accumulation and its correlation with MRI gadolinium contrast, DWIG enables real-time identification of tumor boundaries. This technique has demonstrated utility in various tumor types and post-radiation necrosis. Future integration with artificial intelligence and augmented reality technologies may bring advanced surgical precision and support. Expanding ICG applications in brain and spinal tumor surgeries appears to improve both safety and treatment outcomes.

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