磁共振弥散张量纤维束示踪成像在脑肿瘤手术中的应用

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1、磁共振弥散张量纤维束示踪成像在脑肿瘤手术中的应用程华俞正勇陈祥江苏省盐城市阜宁县人民医院神经外科摘要：目的：探讨弥散张量纤维束成像(diffusiontensortractography,DTT)其在脑肿瘤中的应用价值。方法:对83例脑肿瘤行常规MRI及DTT检查，通过获取部分各向界性图(FA图)、彩色编码张量图及脑白质纤维束图，依次分析83患者肿瘤与瘤周白质纤维束之间的关系。测量83脑肿瘤患者肿瘤实质区、瘤周水肿区、邻近白质区及对侧正常白质区的ADC值、FA值。结果:ADC值在肿瘤实质区,瘤周

2、水肿区，邻近白质区屮，低级别胶质瘤与高级别胶质瘤具有差异性，而在正常口质区差异不具有统计学意;FA值在肿瘤实质区，低级别胶质瘤与高级别胶质瘤具有差界性，而在瘤周水肿区，邻近白质区中，正常白质区差界不具有统计学意义。月丄3例良、恶性肿瘤瘤周白质纤维束都可以发牛移位;瘤周水肿区白质纤维束表现为浸润和破坏为主，其破坏程度与肿瘤的恶性程度呈正比。结论:DTT可直观显示脑口质损伤程度并观察神经纤维束受损范围。关键词：良恶性脑肿瘤;弥散张量纤维束成像;脑白质纤维束;作者简介：俞正勇，E-ma订：315557

3、593@qq.com收稿日期:2017-09-13基金：2013年盐城市医学科技发展计划项冃(NO.YK2013081)Theclinicalvalueofusingdiffusiontensortractograyhy(DTT)technologytoshowtherelationshipbetweenbenign,malignantbraintumorChengHuaYuZheng-yongChenXiangDepartmentofNeurosurgery,FuningCountyPeopl

4、e'sHospital;Abstract：ObjectiveToinvestigatetheclinicalvalueofusingdiffusiontensortractograyhy(DTT)technologytoshowtherelationshipbetweenbenign,malignantbraintumorandthesurroundingwhitematterfibertractanatomybeforesurgery.MethodsConventionalMR1andDTTw

5、ereperformedin83patientswithbenignormalignantbraintumor.Respectivefractionalanisotropy(FAimage),tensorcolor-codedimageandwhitematterfiberbundlewerecol1ected.Measureandanalyzethetumorparenchyma,pcritumoraledema,ncighboringwhitematterareaemdcontralatcr

6、alnormalwhitematterADCvalues,FAvalues.ResultTheADCvaluesoftumorparenchyma,peritumoraledema,neighboringwhitematterareaweresignificantlydifferentbetweenhigh-levelandlow-levelgliomasandcontralateralnormalwhitematterADCvalueshavenosignifiedntdiffercnco.F

7、Avaluesoftumorparenchymeiweresignificantlydifferentbetweenhigh-levelandlow-levelgliomaswhiletheotherFAvalueshavenosignificantdifference.AndWhitematterfibertractscanbedisplacedintotalof83patientswithbenignormalignantbraintumor;whitematterfibertractsin

8、tumoredemamainlyshowinfi1trationanddestruetion.Theextendofdcstructionisproportionaltothedegreeofmalignancy.ConclusionDiffusiontensortractograyhy(DTT)couldbehelpfulinjudgingthedegreeofthetumorandaccuratelyshowtherelationshipoftumorandsurroundingwhitem