血氧水平依赖功能磁共振成像在脑功能区肿瘤患者的应用

Application of BOLD-fMRI on intracranial tumors in brain motor cortex areas

目的:利用血氧水平依赖功能磁共振技术(BOLD-fMRI),评估肿瘤位于或邻近脑皮层运动功能区的良、恶性肿瘤患者的脑皮层运动功能激活区形态和位置变化,比较和分析两者间激活区体积和最大信号强度的差异。方法:收集30例病理学证实肿瘤位于或邻近脑皮层运动功能区的脑肿瘤患者(恶性肿瘤18例,良性肿瘤12例),应用BOLD-fMRI技术,检查时患者双手同时对指运动,获得脑皮层运动功能区的激活图像,应用工作站对原始数据进行后处理,获得功能区激活图,并与解剖图融合,显示良、恶性肿瘤患者的患侧和健侧脑皮层运动激活区形态和位置;应用SPM 5软件计算和分析双侧脑皮层运动激活区的激活体积及最大信号强度,并用统计学方法分析各组间的差异。结果:肿瘤患侧脑皮层运动功能激活区的范围减小、形状变细长、主要向前或外侧移位;恶性肿瘤的脑皮层运动功能激活区的激活体积和最大信号强度明显小于良性肿瘤者(P<0.01)。所有肿瘤患侧脑皮层运动功能激活区的激活体积和最大信号强度明显小于健侧(P<0.01)。结论:BOLD-fMRI能直观地显示肿瘤患者脑皮层运动功能激活区的形态和位置变化,有助于外科手术方案的制定;良、恶性肿瘤组之间,肿瘤组与健侧组之间的脑皮层运动功能激活区的激活体积和最大信号强度具有显著性差异。

Objective：To evaluate changes of the morphology of brain motor cortex areas （BMCAs） on patients with tumors, which located in or close to BMCAs,by blood oxygenation level dependent functional magnetic resonance imaging （BOLD-fM- RI）. Activation volume （AV） and the largest signal intension （LSI） data were analyzed and compared between data obtained from the side of the brain affected by tumors and the contralateral side. Methods： Thirty patients with tumors （18 malignant and 12 benign tumors were proved by histopathology） in or directly adjacent to BMCAs were studied with BOLD-fMR imaging （finger-tapping paradigm）. Activation MR imaging were obtained and images were superimposed with anatomy imaging of the functional area by SPM software which manipulated the raw data in the work station. And the changes of the morphology and location of BMCAs were noted between groups of benign and malignant tumors, between the side of brain affected by tumors and the contralateral side. AV and LST data of the bilateral BMCAs were analyzed by Statistics. Results： Extent of BMCAs were small narrow, which shifted anterolaterally on the side of brain affected by tumors. AV and LSI on the group of the ma- lignant tumors were significantly smaller compared with the group of benign tumors （ P 〈0.01）; AV and LSI on all tumors were significantly smaller compared with the contralateral side （ P 〈0.01）. Conelusion： Changes of the morphology and site of BMCAs of affected by all tumors and contralateral were showed directly with BOLD-fMRI. They are helpful in making surgical plans. There are significant differences in AV and LSI of the BMCAs between the side of all tumors and contralateral side, and the group of malignant tumor compared with the group of benign tumor.