磁共振弥散张量成像在运动功能区星形胶质细胞瘤手术中的运用  

Application of the MRI diffusion tensor imaging for the astrocytic tumor in motor function area

作　　者：陈建[1] 万政强[2] 施炜[1] 李敏[3] 

机构地区：[1]南通大学附属医院神经外科,226001 [2]南通大学附属盐城市人民医院神经外科 [3]南通大学附属医院影像中心

出　　处：《中华神经外科杂志》2009年第9期829-831,共3页Chinese Journal of Neurosurgery

摘　　要：目的探讨磁共振弥散张量成像（DTI）在运动区脑星形胶质细胞瘤恶性程度预测及手术方案制定的临床应用价值。方法33例运动功能区星形细胞瘤患者，术前进行DTI检查，测量表观弥散系数（ADC值）及各向异性分数（FA值）并重建三维白质纤维束示踪图（DTT图）。结果不同级别星形细胞瘤的肿瘤实质区ADC值及瘤周水肿区FA值存在差异；DTF图可以清楚显示运动区锥体束形态变化及与肿瘤之间的关系，在此基础上指导手术，效果满意。结论DTI中ADC、FA值可以区别肿瘤组织与正常神经组织，有助于星形细胞瘤分级；DTF图可以优化运动功能区星形细胞瘤切除的手术方案，可最大范围切除肿瘤并有效保护重要白质纤维束。Objective Astrocytic tumors in motor area often grow infiltratively with worse outcome. It is significant to identify the tumor infiltrating field before the operation to improve the outcome of surgery. Diffusion tensor imaging（DTI） is an advanced quantitative form of diffusion -weighted imaging. The study is to discuss the clinical application of DTI in identifying, forecasting the grades of astrocytoma and choosing the best procedure for resecting astrocytonla. Method The clinical data of consecutive 33 patients with astrocytoma in motor function area underwent DTI examination before the operation. Results Compared with normal brain tissue, significant differences of ADC and FA were found in solid area of astrocytoma necrotic region, edema region （ P 〈 0. 05 ）. Significant differences of ADC were also found in solid tumor compared with necrotic region and edema region respectively （ P 〈 0. 05 ）. By the imaging guidance of DTI, we could show white matter fiber tracts of the motor area and evaluate the relationship between astrocytoma and white matter fiber for the operation. Conclusions ADC and FA can be used to differentiate normal brain tissue from astrocytoma. According to the change of white matter fiber tracts around the tumors in DTT, we could optimize the operational project and improve the resection of astrocytoma significantly, as well as to decrease potential disability after operation.

关 键 词：星形细胞瘤 磁共振成像 弥散 

分 类 号：R686[医药卫生—骨科学]