脑胶质瘤的弥散张量成像的初步研究  

Preliminary Study of Gliomas by Diffusion Tensor Imaging

作　　者：廖丹玲[1] 梁碧玲[1] 谭湘萍[1] 张卫东[1] 钟镜联[1] 叶瑞心[1] 

机构地区：[1]中山大学孙逸仙纪念医院放射科,广东广州510120

出　　处：《中国神经肿瘤杂志》2005年第3期160-165,共6页Chinese Journal of Neuro-Oncology

摘　　要：背景与目的:胶质瘤是脑内最常见的肿瘤,其弥漫性浸润的特点给诊断和治疗带来了很大的困难,术前区分肿瘤的不同成分及正常脑组织,明确重要纤维柬浸润情况有重要的意义。本研究探讨各向同性显著扩散系数(isotropie apparent diffusion coefficient,ADCiso)值与部分各向异性(fractional anisotropy,FA)值的测定在区分肿瘤不同组织成分与正常脑组织中的作用。测定肿瘤侧锥体束通过不同解剖部位的FA值,探讨星形细胞瘤病例肿瘤对锥体束侵犯的情况。方法:对确诊的35例胶质瘤进行弥散张量成像(diffusion tensor imaging,DTI),测定肿瘤实质强化部分、肿瘤实质不强化部分、瘤内囊变坏死组织、瘤周水肿组织及周围正常脑白质的ADCiso值和FA值:对6例Ⅰ-Ⅱ级,7例Ⅲ-Ⅳ级幕上型累及单侧大脑半球的病例,测定锥体束通过不同区域的FA值。结果:肿瘤实质组织、瘤内囊变坏死区、瘤周水肿组织的ADCiso值同正常脑组织相比均有显著性差异,肿瘤实质组织、囊变坏死组织、瘤周水肿组织ADCiso值之间比较有显著差异。肿瘤实质组织、瘤内囊变坏死组织、瘤周水肿组织的FA值同正常脑组织比较均有显著差异;肿瘤实质组织的FA值同瘤内囊变坏死组织、瘤周水肿组织比较无显著差异:瘤内囊变坏死组织FA值同瘤周水肿组织比较无显著差异。高级别星形细胞瘤病例中,肿瘤最大层面、内囊后肢层面肿瘤侧锥体束FA值较健侧低,中脑大脑脚、桥脑层面锥体束肿瘤侧FA值与健侧比较无显著差异;低级别星形细胞瘤病例中,肿瘤最大层面、内囊后肢层面、中脑大脑脚、桥脑层面锥体束肿瘤侧FA值与健侧比较均无显著差异。结论:ADCiso值可以区别肿瘤实质组织、瘤内囊变坏死区、瘤周水肿组织、正常脑组织。FA值可将肿瘤实质组织、瘤内囊变坏死区、瘤周水肿区与正常脑组织区别,但不能将肿瘤实质组织、瘤�BACKGROUND ＆ OBJECTIVE：Glioma is the most common type of primary brain tumor with characteristic of spreading and infiltrating along white matter. Information about differentiating solid tumor, necrotic area, edema region from normal brain tissue and about tumor cells invasion into white matter are very important for treatment planning. This study was designed to evaluate the usefulness of ADCiso and FA values in differentiating solid tumor, necrotic region, edema area, normal brain tissue of the glioma patients and to detect pyramidal tract invasion in astrocytomas by measuring the FA values of fiber pathway. METHODS： Thirty-five cases of glioma tumors confirmed by pathology were examined by diffusion tensor imaging （DTI）. ADCiso, FA values of different tissue were measured in regions of solid tumor, necroticarea, edema area, and normal brain tissure. In 6 cases with supratentorial astrocytic tumors grade Ⅰ -Ⅱ and 7 cases grade Ⅲ-Ⅳ, FA values were measured on pyramidal tract pathway. RESULTS： Significant differences of ADCiso were found in solid tumor, necrotic region, and edema region compared with normal brain tissure. Significant differences of ADCiso were also found in solid tumor compared with necrotic region, edema region. Significant differences of FA were found in solid tumor, necrotic region, edema region compared with normal brain tissue, while there was no differences of FA were revealed in solid tumor, necrotic region and edema region. In high-grade astrocytic tumors, the regions of pyramidal tract on the slice which the tumor nearest the tract and internal capsule showed lower FA values than that contralateral corresponding regions. The areas on the cerebral peduncles and pons slice showed no difference of FA values with contralateral corresponding regions. In low-grade astrocytic tumors, no difference of FA values were found in tumors side and unaffected side on the regions of pyramidal tract on the four slices. CONCLUSION： Determination of ADCiso could be used to differentiat

关 键 词：胶质瘤 星形细胞瘤 磁共振成像 弥散 张量 

分 类 号：R739.41[医药卫生—肿瘤]