弥散张量纤维束成像在脑干肿瘤手术的应用

Appliance of diffusion tensor imaging in the resection of brainstem tumors

目的评估磁共振弥散张量成像(DTI)技术在脑干肿瘤手术中的应用价值。方法报告6例脑干肿瘤患者,依据DTI确定不同的手术方案。结果肿瘤全切除4例,次全切除2例;病理检查证实胶质瘤4例,海绵状血管瘤2例;术前Rankin量表平均为2.22分,术后评分下降0.56分,平均为1.66分。结论 DTI能揭示脑干肿瘤与受累白质纤维束的关系,有助于优化手术方案;为提高手术效果,建议有条件可以考虑将DTI列为脑干肿瘤术前常规检查项目。

Objective To evaluate the value of diffusion tensor imaging （DTI） technique in neurosurgical treatment for brainstem tumors. Methods Six patients with brainstem tumors underwent white matter fiber tractography by using DTI technique before the operation.Then the reasonable surgical plan was established. Results Total resection was achieved in 4 patients,partial resection was performed in 2 patients.In this group, 4 cases were gliomas, 2 cases were cavernomas. The preoperative average Rankin score was 2.22 points, the average postoperative score had improved by 0.56 points to 1.66 points. Conclusion DTI can provide valuable information regarding the relationship between the principal fiber tracts and brainstem tumors, which is useful in guiding the surgical approach and extent of resection.We suggest that DTI should become a routine preoperative examination for brainstem lesions.