弥散张量及纤维束成像在累及脑干肿瘤评估内侧丘系的研究

Diffusion tensor imaging and diffusion tensor tractography in brainstem tumors with the mediallemnnicus invaded

目的探讨磁共振DTI及DTr技术在累及脑干肿瘤手术中评估内侧丘系的应用价值。方法收集经手术病理证实的25例累及脑干肿瘤患者，肿瘤位于脑干或脑于周边，所有肿瘤均对脑干有不同程度的影响，男14例，女11例，年龄4～59岁，平均23．7岁；另收集25例健康对照组，年龄6～58岁，平均24．7岁，所有患者及健康对照均行DTI扫描。结果DTI及DTr技术能用于累及脑干肿瘤内侧丘系的损伤分级，所有病变与内侧丘系的位置关系均得到很好显示，术后所有患者均未出现新的神经系统症状，术前8例评级为中度缺失的患者，5例术后评级为轻度缺失，术前6例评级为轻度缺失的患者，4例术后评级为无缺失。结论DTI及DTr技术能直观显示脑干内侧丘系与肿瘤的位置关系，对术中保护内侧丘系及术后评估纤维束的恢复情况有重要的临床意义。

Objective To explore the change of medial lemniscus of brainstem tumors and its surrounding tumors with 3.0 T MR for the use of diffusion tensor imaging （DTI） and diffusion tensor tractography （DTF）technology. Methods 25 cases brainstem tumors and its surrounding tumors were analyzed. There are 14 males and 11 females, and the age ranged from 4 to 59 years with the mean age of 23.7 years, as well as 25 cases normal controls match with gender and age. All patients and normal controls were performed DTI scan. Results DTI and DTI technology can be used to evaluation of corticospinal tract and medial lemnicus. The DTI and DTY technology can two- and three-dimensionally shows the spatial relation of tumors and fiber tracts. Conclusions The DTI and DTY technology can shows the relationship of tumors and fiber tracts. It is very important to protect these fiber tracts in the perioperative, as well as monitoring prognosis.