磁共振扩散张量成像技术在脑肿瘤手术前后的临床应用价值

发布时间：2018-01-06 09:00

本文关键词：磁共振扩散张量成像技术在脑肿瘤手术前后的临床应用价值　出处：《临床放射学杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的探讨磁共振扩散张量成像(DTI)技术显示手术前后不同级别脑肿瘤与邻近白质纤维束关系的变化情况及预后。方法对30例经病理证实的脑肿瘤患者,于术前3天、术后1个月行常规MRI及DTI扫描。利用各向异性分数(FA)图测量肿瘤邻近白质纤维束在手术前后及健侧相同位置纤维束的表观扩散系数(ADC)及FA。重组肿瘤邻近白质的纤维束示踪(DTT)图,对比手术前后白质纤维束的位置、形态及完整性并判断患者预后。结果低级别脑肿瘤对邻近白质纤维束的影响以推移、挤压为主,与健侧纤维束比较FA值升高、ADC值减低(P0.05),术后纤维束形态、位置逐渐恢复正常,FA值及ADC值趋同于健侧,大部分患者的神经系统功能明显改善;高级别脑肿瘤对邻近白质纤维束普遍存在浸润、破坏,术前纤维束的FA值减低,ADC值明显增高(P0.01),术后虽将肿瘤大部切除,邻近纤维束的FA值及ADC值仍无明显改善,中断、破坏的纤维束亦无恢复,患者的预后明显较低级别组差(P0.05)。结论 DTI技术可在活体清晰、无创地显示肿瘤与邻近白质纤维束的关系,对不同级别肿瘤患者的预后判断具有参考价值。
[Abstract]:Objective to explore the magnetic resonance diffusion tensor imaging (DTI) technique showed different levels before and after the surgery of brain tumors and adjacent white matter tracts between the changes and prognosis. Methods 30 cases of patients with brain tumors confirmed by pathology, 3 day before surgery, underwent conventional MRI and DTI scan 1 months after operation. The use of an specific fraction (FA) measured tumor adjacent white matter fiber bundle apparent diffusion coefficient before and after the operation of the contralateral same position of fiber bundle surface (ADC) fiber and recombinant FA. tumors adjacent white matter tractography (DTT) map contrast before and after the operation of white matter fiber position, morphology and integrity and prognosis of patients the results of judgment. Low level of brain tumors on adjacent white matter fiber to goes on, the main squeeze, with the contralateral fibers compared with the FA value increased, ADC value decreased (P0.05), postoperative fiber morphology, position gradually returned to normal, FA and ADC values similar to the healthy side, most of the patients The function of the nervous system is obviously improved; the high-level brain tumor on the adjacent white matter fiber widespread infiltration, destruction, preoperative fiber bundle FA value decreased, the ADC value was significantly higher (P0.01), although most of the patients after tumor resection, the adjacent fiber bundles of FA value and ADC value is still no significant improvement, interrupt no, the fiber bundle failure recovery, the prognosis of patients with significantly lower level group (P0.05). Conclusion DTI can be applied to in vivo clear, non invasively displays the relationship between tumor and adjacent white matter fiber, it has reference value for the prognosis of patients with different levels of tumor judgment.

【作者单位】：中国医科大学附属第一医院;
【分类号】：R445.2;R739.41
【正文快照】： 作者单位:110000中国医科大学附属第一医院;*通讯作者颅脑肿瘤是神经外科最常见的疾病之一[1],研究表明肿瘤的全切率与复发率呈负相关[2]。但是,如何平衡累及或邻近重要脑功能区肿瘤的切除率与功能保护二者之间的关系至关重要[3]。传统磁共振(magnetic resonance imaging,MRI)

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