磁共振弥散张量纤维束示踪成像在脑肿瘤手术中的应用

The clinical value of using diffusion tensor tractograyhy(DTT) technology to show the relationship between benign, malignant brain tumor

目的:探讨弥散张量纤维束成像(diffusion tensor tractography,DTT)其在脑肿瘤中的应用价值。方法:对83例脑肿瘤行常规MRI及DTT检查,通过获取部分各向异性图(FA图)、彩色编码张量图及脑白质纤维束图,依次分析83患者肿瘤与瘤周白质纤维束之间的关系。测量83脑肿瘤患者肿瘤实质区、瘤周水肿区、邻近白质区及对侧正常白质区的ADC值、FA值。结果:ADC值在肿瘤实质区,瘤周水肿区,邻近白质区中,低级别胶质瘤与高级别胶质瘤具有差异性,而在正常白质区差异不具有统计学意;FA值在肿瘤实质区,低级别胶质瘤与高级别胶质瘤具有差异性,而在瘤周水肿区,邻近白质区中,正常白质区差异不具有统计学意义。且83例良、恶性肿瘤瘤周白质纤维束都可以发生移位;瘤周水肿区白质纤维束表现为浸润和破坏为主,其破坏程度与肿瘤的恶性程度呈正比。结论:DTT可直观显示脑白质损伤程度并观察神经纤维束受损范围。

Objective To investigate the clinical value of using diffusion tensor tractograyhy(DTT) technology to show the relationship between benign, malignant brain tumor and the surrounding white matter fiber tract anatomy before surgery. Methods Conventional MRI and DTT were performed in 83 patients with benign or malignant brain tumor. Respective fractional anisotropy(FA image), tensor color-coded image and white matter fiber bundle were collected. Measure and analyze the tumor parenchyma, peritumoral edema, neighboring white matter area and contralateral normal white matter ADC values, FA values. Result The ADC values of tumor parenchyma, peritumoral edema, neighboring white matter area were significantly different between high-level and low-level gliomas and contralateral normal white matter ADC values have no significant difference. FA values of tumor parenchyma were significantly different between high-level and low-level gliomas while the other FA values have no significant difference. And White matter fiber tracts can be displaced in total of 83 patients with benign or malignant brain tumor; white matter fiber tracts in tumor edema mainly show infiltration and destruction. The extend of destruction is proportional to the degree of malignancy. Conclusion Diffusion tensor tractograyhy(DTT) could be helpful in judging the degree of the tumor and accurately show the relationship of tumorand surrounding white matter fi ber clearly.