摘要
目的:探讨3.0T磁共振弥散张量成像(diffusion tensor imaging,DTI)技术在脑胶质瘤分级诊断及手术指导中的应用价值。方法:选取2019年1月—2022年1月于运城市中心医院经病理证实为胶质瘤的病例25例,收集病例术前DTI检查结果数据,应用后处理工作站进行分析,分析胶质瘤病灶区、周围水肿区、相邻白质区及对侧正常白质区的表观弥散系数(apparent diffusion coefficient,ADC)值、各向异性分数(fractional anisotropy,FA)值。结果:25例患者中10例Ⅰ~Ⅱ级胶质瘤患者的肿瘤周围区域纤维束推移,患者术后临床表现改善明显;15例Ⅲ~Ⅳ级胶质瘤浸润、破坏相邻脑白质纤维束,患者术后临床症状未明显改善或改善较差;低级别胶质瘤及高级别胶质瘤肿瘤相应瘤周水肿区的ADC值高于实质区;低级别胶质瘤相邻白质区ADC值低于高级别胶质瘤,但差异无统计学意义(P>0.05);低级别胶质瘤病灶区与对侧正常白质区ADC值低于高级别胶质瘤,周围水肿区ADC值高于高级别胶质瘤,差异均有统计学意义(P<0.05)。低、高级别胶质瘤周围水肿、相邻白质区、对侧正常白质区FA值差异均无统计学意义(P>0.05),高级别胶质瘤病灶区FA值高于低级别胶质瘤,差异具有统计学意义(P<0.05)。结论:DTI纤维束成像技术可以清晰显示胶质瘤与周围脑白质纤维束的关系,DTI结合常规颅脑MRI检查,通过后处理病灶区及周围脑实质区的ADC值联合FA值,有助于高、低级别胶质瘤的鉴别诊断以及周围脑实质浸润范围的评估。对胶质瘤患者术前手术方案的选择和评估以及术后患者的预后预测具有重要参考意义。
Objective To explore the application value of 3.0T magnetic resonance diffusion tensor imaging(DTI)in grading diagnosis and surgical guidance of gliomas.Methods 25 cases of glioma confirmed by pathology in Yuncheng Central Hospital from January 2019 to January 2022 were selected,the data of preoperative DTI were collected and analyzed by post-processing workstation,the apparent diffusion coefficient(ADC)and fractional anisotropy(FA)of glioma focus area,surrounding edema area,adjacent white matter area and contralateral normal white matter area were analyzed.Results In 10 of 25 patients with gradeⅠ-Ⅱgliomas,the fibrous bundles around the tumor moved,and the clinical manifestations of the patients improved obviously after operation.15 patients with gradeⅢ-Ⅳgliomas infiltrated and destroyed the adjacent white matter fiber bundles,and the postoperative clinical symptoms were not significantly improved or poorly improved;The ADC value of the corresponding peritumoral edema area of low-grade glioma and high-grade glioma was higher than that of the solid area;The ADC value of adjacent white matter area of low grade glioma was lower than that of high grade glioma,but the difference was not statistically significant(P>0.05);The ADC value of low-grade glioma focus area and contralateral normal white matter area was lower than that of high-grade glioma,and the ADC value of peripheral edema area was higher than that of high-grade glioma,the difference was statistically significant(P<0.05).There was no statistically significant difference in FA values of peripheral edema,adjacent white matter area and contralateral normal white matter area between low and high grade gliomas(P>0.05);The FA value of high grade gliomas is higher than that of low grade gliomas,and the difference was statistically significant(P<0.05).Conclusion DTI fiber bundle imaging technique can clearly show the relationship between glioma and surrounding white matter fiber tracts,has important reference significance for the selection and evaluation of preoperative surgical procedures and postoperative prognosis of glioma patients;DTI combined with routine craniocerebral MRI examination is helpful for the diagnosis of high and low grade gliomas.
作者
秦粽园
郭兴华
张晓红
史汉明
王晋君
QIN Zongyuan;GUO Xinghua;ZHANG Xiaohong;SHI Hanming;WANG Jinjun(Department of Medical Imaging,Yuncheng Central Hospital,Yuncheng,Shanxi 044000,China)
出处
《影像研究与医学应用》
2023年第5期55-58,共4页
Journal of Imaging Research and Medical Applications
关键词
胶质瘤
弥散张量成像
磁共振成像
Glioma
Diffusion tensor imaging
Magnetic resonance imaging