弥散张量成像对胶质瘤手术切除程度的早期评估价值研究

发布时间：2019-01-10 11:59

【摘要】：目的:研究弥散张量成像对胶质瘤手术切除程度及预后的早期评估。方法:选取在山西医科大学第一临床医学院神经外科住院手术治疗,且在术中影像学基础上达到尽全切,剔除术后3个月肿瘤进展病例后符合标准的20例患者,年龄42~79岁,平均(57.95±10.82)岁,其中男11例,女9例。采用直接测量法及弥散张量成像(DTI)辅助测量法对20例胶质瘤患者行术前、术后72 h及术后3个月的扫描,在术后MRT1加权像上不同层面分别手工描记残余肿瘤边界,获取术后72 h及术后3个月残余肿瘤体积进行比较分析。结果:经直接测量法获取术后72 h残余肿瘤体积明显大于DTI辅助测量法获取的术后72 h残余肿瘤,差异有统计学意义(t=4.924,P0.001),直接测量法获取术后3个月残余肿瘤体积明显大于DTI辅助测量法获取的术后3个月的残余肿瘤,差异有统计学意义(t=2.311,P=0.026)。经直接测量法获取的术后72 h残余肿瘤体积明显大于术后3个月的残余肿瘤,差异有统计学意义(t=10.013,P0.001),经DTI辅助测量法获取的术后72 h残余肿瘤体积明显大于术后3个月的残余肿瘤,差异有统计学意义(t=7.389,P0.001)。结论:将DTI技术用于评估胶质瘤手术切除程度,能够保护患者的神经系统功能,提高手术疗效评估的准确性。
[Abstract]:Objective: to study the early evaluation of surgical resection and prognosis of glioma by diffusive Zhang Liang imaging. Methods: twenty patients, aged 42 to 79 years, who were admitted to the Department of Neurosurgery in the first College of Clinical Medicine of Shanxi Medical University and who had achieved complete resection on the basis of intraoperative imaging, were excluded from the cases of tumor progression 3 months after operation. The mean age was (57.95 卤10.82) years, including 11 males and 9 females. 20 cases of glioma were scanned by direct measurement method and diffusion-Zhang Liang (DTI) assistant measurement before operation, 72 hours after operation and 3 months after operation. The boundary of residual tumor was manually recorded on different levels of MRT1 weighted images after operation. The residual tumor volume at 72 hours and 3 months after operation was compared and analyzed. Results: the volume of residual tumors obtained by direct measurement at 72 hours after operation was significantly larger than that obtained by DTI adjuvant measurement at 72 hours after operation, and the difference was statistically significant (t = 4.924, P 0.001). The volume of residual tumor obtained by direct measurement at 3 months after operation was significantly larger than that at 3 months after operation by DTI method, and the difference was statistically significant (t = 2.311P < 0.026). The volume of residual tumor obtained by direct measurement at 72 hours after operation was significantly larger than that at 3 months after operation, and the difference was statistically significant (t = 10.013, P 0.001). The volume of residual tumor at 72 hours after operation was significantly larger than that at 3 months after operation, and the difference was statistically significant (t = 7.389, P 0.001). Conclusion: the application of DTI in the evaluation of surgical resection of gliomas can protect the nervous system function of patients and improve the accuracy of surgical evaluation.
【作者单位】：山西医科大学;山西医科大学第一临床医学院;
【分类号】：R445.2;R739.4

【参考文献】