DTI多参数综合分析在颅内星形细胞瘤临床分级及神经外科手术中的应用价值研究  

The clinical and surgical application of DTI multiple parameter value and DTT in astrocytomas

作　　者：孙夕林[1] 王丹[1] 申宝忠[1] 李琳[1] 何琦玮[1] 刘芳[1] 

机构地区：[1]哈尔滨医科大学附属第四医院,黑龙江哈尔滨150000

出　　处：《中国临床医学影像杂志》2009年第9期677-680,692,共5页Journal of China Clinic Medical Imaging

基　　金：黑龙江省科技计划(项目编号:GC06C40703)

摘　　要：目的:探讨DTI多参数综合分析及DTT技术在星形细胞瘤分级、术前计划制定、术后疗效评价中的应用价值。方法:星形细胞瘤患者33例,术前和/或术后行常规T1WI、T2WI、T1WI增强、DTI检查。测量病灶不同区域及对侧正常白质区的DCavg值、FA值、ADC值、1-VR值及RA值;扩散张量纤维束成像(DTT)重建病变周围脑白质纤维束。结果:各组中的病灶不同区域的各测量值均存在显著差异(P<0.05)。低级别星形细胞瘤肿瘤周围的白质纤维束多呈推挤水肿改变,2例患者术后白质纤维束移位水肿减轻,预后良好,而高级以浸润破坏为主,3例患者术后无改善。结论:DTI多参数均有助于区分肿瘤不同区域,有助于低、高级别星形细胞瘤的鉴别;DTI及DTT有助于肿瘤患者术前计划的制定和手术效果的评价。Objective： To investigate the clinical usefulness of DT! multiple parameter and diffusion tenser tracting（DTT） in astrocytomas. Methods： Thirty-three cases of astrocytomas underwent routine MRI, enhanced scanning and DTI before and/or after operation. DCavg, FA, 1-VR and RA values were measured in the solid part of tumors, the necrotic area, the peritumoral edema, the white matter area surrounding the edema and corresponding normal brain; and the white matter surrounding tumors were rebuilt with DTT. Results： The white matter of brain could be seen better in FA and DTI graph, and not in routine MRI. There was significant difference of ADC, DCavg, FA, 1-VR and RA values in the solid part of tumors, the necrotic area, the peritumoral edema and the white matter area surrounding the edema. The peritumoral white matter of most low-grade astrocytoma cases were displaced, while of high-grade astrocytomas were destroyed. Conclusion： Combined with conventional MR imaging, DCavg, FA, 1-VR and RA values were conduced to distinguish the solid part of tumors, the necrotic area, the peritumoral edema and the white matter area surrounding the edema in distinguishing astrocytoma grade; FA, 1-VR, and RA value were conduced to detect low-grade and high-grade astrocytomas. DTI and DTT can be used to select the better operation methods and evaluate effect of operation.

关 键 词：脑肿瘤 星形细胞瘤 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R730.264[医药卫生—临床医学]