枕部肿瘤患者视觉功能障碍的静息态fMRI研究

发布时间：2018-03-11 07:07

本文选题：脑肿瘤　切入点：视功能　出处：《重庆医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的采用静息态功能磁共振成像（RS-fMRI）和独立成分分析（ICA）方法对正常人以及枕部脑肿瘤术前患者进行视中枢功能空间定位，评价其在枕部病变治疗计划制定以及预后评估中的价值。方法采集在年龄、性别和左右利手上与患者组相匹配的19例志愿者（正常对照组）及8例枕部脑肿瘤患者（患者组）术前RS-fMRI数据和临床视野检查资料，利用ICA方法提取所有受试者的Brodmann17区及18区视中枢网络。由两位高年资神经影像医师观察记录正常对照组的视中枢网络表现，然后在不知道临床视野检查结果的情况下，观测视中枢网络完整性和分布情况，并与临床视野检查结果进行比较。结果 RS-fMRI显示正常对照组双侧视觉皮层Brodmann17区及18区视中枢网络完整存在；患者组Brodmann17及18区的视中枢网络连接强度和范围与正常对照组及健侧比较有不同程度降低，视中枢功能区明显受压移位者5例，视中枢完整性受损者6例，邻近脑区视觉网络连接增强者6例，肿瘤周围视中枢网络连接增强者4例。术前视野检查存在视野缺损的2例患者均显示视中枢网络完整性受损，邻近脑区视觉功能代偿，肿瘤周围视中枢未见代偿；视野正常的6例中有2例视中枢网络完整性基本存在，其余4例视中枢网络完整性受损，，肿瘤周围及邻近脑区视觉功能可见代偿。结论 RS-fMRI检查可满意地获取正常人脑的静息态视中枢网络分布，可帮助判断枕部脑肿瘤患者视中枢网络完整性，其表现与传统临床视野检查结果有较好一致性，并且此方法更具客观性，患者依从性也更好。枕部脑肿瘤患者视中枢可能发生受压移位、完整性受损或存在代偿功能区，应用RS-fMRI方法对其进行准确定位，可帮助临床制定手术或放疗计划并评估患者视觉预后。
[Abstract]:Purpose. Resting functional magnetic resonance imaging (RS-f MRI) and independent component analysis (ICA) were used to locate the visual function of normal subjects and patients with occipital brain tumors before operation, and to evaluate its value in the treatment plan and prognosis of occipital lesions. Method. RS-fMRI data and clinical visual field examination data were collected from 19 volunteers (normal control group) and 8 patients with occipital brain tumor (patient group) matched with patients with age, sex and left and right hands. ICA method was used to extract the visual central network of all the subjects in the Brodmann17 and 18 regions. Two senior neuroimaging physicians observed and recorded the manifestations of the visual central network in the normal control group, and then did not know the results of the clinical visual field examination. The integrity and distribution of visual central network were observed and compared with the results of clinical visual field examination. Results. RS-fMRI showed that the visual central network of bilateral visual cortex Brodmann17 and 18 was intact in normal control group, and the intensity and range of optic central network connection in Brodmann17 and 18 regions in the patient group were lower than those in the normal control group and healthy side. There were 5 cases with obvious compression displacement of the visual central functional area, 6 cases with impaired visual central integrity and 6 cases with enhanced visual network connection in the adjacent brain area. All the 2 patients with visual field defect showed that the integrity of the visual center network was impaired, the visual function was compensated in the adjacent brain area, and no compensation was found in the surrounding visual center of the tumor. Of the 6 cases with normal visual field, 2 cases had the integrity of the visual central network, while the other 4 cases had impaired visual central network integrity, and the visual function around the tumor and adjacent brain area could be compensated. Conclusion. RS-fMRI can obtain the distribution of resting visual center network in normal human brain satisfactorily, and can help to judge the integrity of optic central network in patients with occipital brain tumor. The results of RS-fMRI are in good agreement with the results of traditional clinical visual field examination. And this method is more objective and patient compliance is better. Occipital brain tumor patients with visual center may be under pressure displacement, integrity damage or the existence of compensatory functional areas, the use of RS-fMRI method to accurately locate it. It can help to make surgery or radiotherapy plan and evaluate the visual prognosis of patients.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.41;R445.2

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