弥散张量成像在髓内肿瘤中的临床应用

发布时间：2018-10-13 17:08

【摘要】：目的:探讨髓内肿瘤的弥散张量成像(DTI)对脊髓髓内肿瘤的诊断与治疗的意义。方法:对7名颈髓髓内肿瘤患者进行影像学检查,项目包括脊髓常规MR扫描、3D扫描及脊髓DTI,根据需要进行纤维束示踪(DTT)重建。仪器设备为3.0T MRTRIOTIM扫描仪(Siemens公司),采用NUMARIS/4软件syngo MRB15版本后处理工作站进行后处理,计算病变去与相对正常颈髓平均扩散系数(Average Diffusion Coefficient ADC)值,部分各向异性(Fractional Anisotropy FA)值。并结合检查结果制定诊疗计划,对效果进行临床观察。观察手术患者术后恢复状况,探讨其对髓内肿瘤的诊断价值。结果:1名患者进行手术治疗,治疗效果满意,术中病变定位与DTI结果一致。其余患者在医生明确交代手术风险后决定暂不手术,将对其定期随访。结论:(1)DTI成像技术可无侵袭性地对髓内肿瘤进行水分子扩散评估。(2)脊髓肿瘤发生时,病变区的FA值、ADC值较正常脊髓组织发生明显变化。(3)DTI能够直观地显示颈髓疾病所致白质神经纤维束的形态学改变,有助于对椎管内占位病变的定位诊断,并指导手术切除。
[Abstract]:Objective: to investigate the significance of diffusive Zhang Liang (DTI) in the diagnosis and treatment of intramedullary tumors of the spinal cord. Methods: imaging examinations were performed in 7 patients with intramedullary tumors of the cervical spinal cord, including routine MR scan of spinal cord, 3D scan and DTI, tracer (DTT) reconstruction of spinal cord. The instrument is a 3.0T MRTRIOTIM scanner (Siemens Company). The post-processing workstation of syngo MRB15 version of NUMARIS/4 software is used for post-processing. The average diffusion coefficient (Average Diffusion Coefficient ADC) and the partial anisotropic (Fractional Anisotropy FA) value of lesion and normal cervical spinal cord are calculated. And combined with the results of the diagnosis and treatment plan, clinical observation. To investigate the diagnostic value of postoperative recovery in patients with intramedullary tumors. Results: one patient underwent surgical treatment with satisfactory results. The localization of pathological changes was consistent with that of DTI. The rest of the patients will be followed up regularly after their doctors have specified the risks of the operation and have decided not to do so for the time being. Conclusion: (1) DTI imaging can noninvasively evaluate intramedullary tumors by water molecular diffusion. (2) when spinal cord tumors occur, (3) DTI can visualize the morphological changes of the white matter nerve fiber bundle caused by cervical spinal cord disease, which is helpful to the localization diagnosis of the space-occupying lesions in the spinal canal and guide the surgical excision.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R739.42

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