磁共振弥散张量成像及纤维束成像对脑胶质瘤分级的诊断价值  

Application of magnetic resonance diffusion tensor imaging and fiber tractography to evaluate the value of diagnostic classification of cerebral gliomas

作　　者：胡鸿博[1] 刘鹏飞[1] 

机构地区：[1]哈尔滨医科大学附属第一临床医学院磁共振诊断中心,哈尔滨150001

出　　处：《磁共振成像》2011年第2期118-122,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的联合应用弥散张量成像(diffusion tensor imaging,DTI)与弥散张量纤维束成像(diffusion tensor tractography,DTT),探讨其在胶质瘤分级诊断中的应用价值。方法 25例脑胶质瘤患者进行常规MR及弥散张量成像,经组织病理学证实其中9例低级别(Ⅰ～Ⅱ级)胶质瘤,16例高级别(Ⅲ～Ⅳ级)胶质瘤,分别测量肿瘤中心的FA值、MD值,并利用纤维束成像技术(DTT)观察、评价胶质瘤周围白质纤维束改变。结果测量、统计低级别胶质瘤组与高级别胶质瘤组瘤体实质的FA值、MD值,其中肿瘤中心的FA值两组间具有统计学差异(P<0.05),而MD值两组间差别不具有统计学意义(P>0.05)。DTT显示9例低级别胶质瘤中白质纤维束的整体形态多基本完整,白质纤维束受压、偏移者7例,部分中断者2例。15例高级别胶质瘤中白质纤维束明显变形移位,14例病变区白质纤维束明显破坏,另有1例Ⅲ级胶质瘤患者的白质纤维束主要表现为受压移位。结论弥散张量成像与弥散张量纤维束成像联合应用,有助于胶质瘤的分级诊断,并能够显示肿瘤与周围脑白质神经纤维的位置关系,指导临床制定手术计划。Objective：To evaluate the brain gliomas by the combination of diffusion tensor imaging （DTI） and diffusion tensor tractography （DTT）,and to discuss its value in cerebral gliomas diagnostic classification.Materials and Methods：Conventional MRI and DTI were performed in 25 patients with histological confirmed as gliomas which conclude 9 low-grade gliomas （WHO grade I-II）,16 high-grade gliomas （WHO grade Ⅲ-Ⅳ）.The values of FA and MD were calculated in the patients’ tumor center.The clinical benefit of DTT in display the brain white matter fiber was evaluated.Results：There was significant difference of FA values in the solid part of tumors between low-grad gliomas and high-grade gliomas （P 〈 0.05）.The MD values in tumors center were different,but no statistical significance （P 〉 0.05）.On the DTT map,7 of 9 low grade gliomas showed fiber bundle deviation,2 of 9 low grade gliomas show partly interruption;15 high grade gliomas patients’ fiber bundle were deviated,14 of 15 high grade gliomas patients’ fiber were obviously destructed.But mainly appear as fiber deviation in 1 gliomas patient.Conclusion：Combination of DTI and DTT could be helpful in judging the degree of the tumor and accurately show the relationship of tumor and surrounding white matter fiber clearly,and provide more information of differential diagnosis.It is great value in surgical plan for patients with cerebral gliomas.

关 键 词：弥散张量成像 弥散张量纤维束成像 胶质瘤 

分 类 号：R730.264[医药卫生—肿瘤] R445.2[医药卫生—临床医学]