锥体束示踪成像技术在经侧裂岛叶肿瘤切除术中的应用

Utilize Tractography of Pyramidal Tracts in Surgical resection of intrinsic insular tumors via transsylvian surgical approach in 18 cases.

目的利用锥体束示踪成像技术指导经侧裂岛叶肿瘤切除手术。方法对18例岛叶肿瘤患者行经外侧裂岛叶肿瘤切除手术,分别在术前和术后两次进行磁共振弥散张量成像(diffusion tensor imaging,DTI),并应用白质纤维束示踪技术(fiber tracking)进行DTI原始影像数据后处理,得到锥体束示踪成像(tractography)。观察手术前后锥体束的形态、结构和空间位置的变化,通过测量其连续性、完整性以及空间位移以评估肿瘤占位效应及经侧裂岛叶肿瘤切除术对锥体束的影响。结果18例患者手术均行经侧裂岛叶肿瘤切除术,13例全切除,5例次全切除。手术前后均实现锥体束示踪成像,在锥体束示踪成像上可以精确测定有效锥体束条数。结论锥体束示踪成像可以清晰显示手术前后锥体束的形态、结构和空间位置及受肿瘤推移幅度,可用于指导经侧裂岛叶肿瘤手术的术前计划。

Objective To objective DTI-based tractography of pyramidal tracts to evaluate surgical resection of intrinsic insular tumors via transsylvian approach. Methods 18 patients with intrinsic insular tumors were examined by MR diffusion tensor imaging and given the surgical resection via transsylvian approach. All data were transferred to a personal computer and were processed with Volume- one and dTV （Tokyo University Japan）. The pre- and post-operative images were compared and correlated with the clinical assessments. Results The tumors were totally or subtotally removed. The diffusion tensor tracking can clearly show the pyramidal tracts before and after surgery. And the changes of the post-operative fiber tracts,depicted by DTI based fiber tracking correlated very well with the clinical findings. Conclusions Pyramidal tractography is a useful technique for evaluating surgical resection of intrinsic insular tumors via transsylvian surgical approach.