枕部肿瘤患者视中枢功能RS-fMRI研究

Resting-state fMRI study of visual function in patients with occipitalia tumor

目的:研究静息态功能磁共振(resting-state functional magnetic resonance imaging,RS-f MRI)观测枕部肿瘤患者视中枢功能状况的可行性,并评估其价值。方法:19例健康志愿者(对照组)和8例枕部肿瘤患者(患者组)的术前RS-f MRI数据及临床视野检查资料,利用独立成分分析(independent component analysis,ICA)方法提取所有受试者的布洛德曼区(brodmann area,BA)17及BA 18视中枢网络,观测2组受试者视中枢分布和网络完整性情况,并与临床视野检查比较。结果:RS-f MRI显示患者组BA 17及BA 18视中枢网络连接强度和范围与对照组及健侧比较有不同程度降低;此外,患者组有5例视中枢功能区明显受压移位,6例网络完整性受损,6例邻近脑区视中枢网络连接增强,4例肿瘤周围视中枢网络连接增强。患者组术前临床检查存在视野缺损的2例均显示视中枢网络完整性受损,邻近脑区视中枢功能可见代偿;视野正常的6例中有4例视中枢网络完整性受损,肿瘤周围及邻近脑区视中枢功能可见代偿。结论:RS-f MRI可显示枕部肿瘤患者视中枢功能状况,对手术或放疗计划的制定及视觉预后评估具有重要价值。

Objective：To evaluate the feasibility of observing visual center with resting-state functional magnetic resonance imaging（RS-fMRI）in patients with occipitalia tumor. Methods：Nineteen normal subjects and 8 patients with occipitalia tumor underwent RSfMRI scanning and vision inspection before operation. All visual center networks in Brodmann area（BA）17 and BA 18 were analyzed using independent component analysis（ICA）. The integrity and distribution of the visual center networks of the subjects were compared with the results of visual field examination. Results：In patient group,the strength and range of connection of visual center networks in BA 17 and BA 18 were reduced to different degrees compared with those of normal control group and healthy side. The visual center function area showed displacement in 5 cases,the integrity of the visual center networks impaired in 6 cases,while the visual function connection in adjacent brain regions showed increase in 6 cases,the connection around tumor demonstrated increase in 4cases. The integrity of the visual center networks of the 2 patients with visual field defect were damaged and visual function connection in adjacent brain regions showed increase. While the integrity of visual center network of 4 out of 6 patients with normal visual field were damaged,the visual function connection in adjacent brain regions and surrounding tumors showed increase and compensation.Conclusion：RS-fMRI could observe visual center networks of patients with occipitalia tumor,therefore,RS-fMRI scanning can help project operation or radiotherapy planning of the tumor and evaluate prognosis of the visual function.