弥散张量成像在胶质瘤术前评估中的应用

Application of diffusion tensor imaging to the preoperative assessment of gliomas

目的探讨磁共振弥散张量成像在胶质瘤术前评估中的价值。方法对19例经病理证实胶质瘤的患者术前进行弥散张量成像,观察白质纤维束与肿瘤的关系,测量肿瘤实质区和周边水肿区的FA值。结果颅内胶质瘤所致白质纤维异常有三种基本改变:移位、浸润和破坏。19例中10例移位伴破坏,5例单纯浸润,4例浸润伴破坏;肿瘤的实质区和周边水肿区的FA值与对侧大脑白质FA值相比较存在显著差异(P(0.05)。肿瘤的实质区和周边水肿区FA值之间无统计学显著差异(P>0.05)。结论弥散张量成像技术可以显示胶质瘤与周围白质纤维束的关系,FA值不能区分肿瘤实质与周边水肿区。

Objective To discuss the value of diffusion tensor imaging in the preoperative assessment of glioma. Methods 19 patients with pathologically confirmed glioma were examined with diffusion tensor imaging. The white matter fiber bundle with the tumor, tumor real area surrounding edema and the FA value were observed. Results There were three basic changes of abnormal white matter fiber caused by intracranial glioma ： shift, infiltration and destruction. 10 of 19 cases were with displacement and damage,5 of 19 cases with simply infiltration and 4 of 19 cases with infiltration and damage. Compared with the contralateral white matter, the FA value of the essence of tumor and surrounding edema area had significant difference （P 〈 0. 05）. But the FA value of essence of tumor and the area surrounding edema had statistical difference （P 〉 0.05）. Conclusions Diffusion tensor imaging can show the relationship of glioma with the surrounding white matter fiber bundle. FA value can not be used to distinguish between real tumor and the surrounding edema area.