弥散张量成像在评价脑岛叶-基底节胶质瘤患者运动功能预后和生活质量中的作用  

The role of diffusion tensor imaging in evaluating the motor outcome and life quality of patients with brain insula- basal ganglia gliomas

作　　者：李智奇[1] 张义[1] 邱天明[1] 秦智勇[1] 李文纲[2] 檀书斌[2] 黄山[2] 陈茂振[2] 

机构地区：[1]复旦大学附属华山医院神经外科,上海200040 [2]复旦大学附属上海市第五人民医院

出　　处：《中华神经外科杂志》2013年第8期801-804,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨相对有效锥体束（rEPT）在评价脑岛叶-基底节（IBG）胶质瘤患者运动功能预后和生活质量中的应用价值。方法手术前、后分别对14例IBG胶质瘤患者行DTI检查，计算肿瘤侧rEPT（rEPTtumor，rEPT1）值。通过Spearman等级相关性分析方法分析rEPT1值与患者运动功能预后和KPS预后评分的相关性，采用配对t检验分析术前、术后短期和长期rEPT1值之间的差异。结果rEPT1值与患者运动功能预后和KPS呈显著的正相关性（P〈0．001）；术前、后短期及长期rEPT1值分别为0．7754±0．0232、0．7197±0．0423、0．9280±0．0231，差异有统计学意义（P〈0．01）。结论rEPT1值有助于评价患者的康复情况，反映神经功能动态恢复过程。Objective To investigate the application value of a new parameter of diffusion tensor imaging（DTI） -the relative effective fibers of pyramidal tract （rEPT） in evaluation of motor outcome in combination with life quality of patients with brain insula - basal ganglia （IBG） gliomas. Methods Diffusion tensor imaging （DT1） was pre - and postoperatively performed on 14 patients, the DTI data was transport into DTI studio software to reconstruct bilateral pyramidal tract and calculate rEPT value at the tumor side （rEPTt ）. Spearman＇s rank correlation method was used to elucidate the relationship between rEPTt value and motor outcome as well as KPS. Moreover the paired t - test was employed to analyze the difference of rEPTt value at 3 different phases of preoperation, short - term and long - term postoperation. Results There were significant positive correlations between rEeFt value and motor outcome as well as KPS （P 〈 0. 001 ）; there were significant differences between preoperative rEPTt value （0. 7754±0. 0232 ）, short - term postoperative rEPT, value （ 0. 7197 ±0. 0423 ） and long - term postoperative rEPTt value （ 0. 9280± 0. 0231 ） （ P 〈 0. 01 ） . The long - term postoperative rEPT, was significantly higher than the preoperative and the short - term postoperative rEPT1 value. Conclusion rEPT1 value is useful in evaluating the rehabilitated condition of patients with IBG gliomas at the early stage; the gradually recovery process change of pre - and postoperative rEPT, values.

关 键 词：弥散张量成像 神经胶质瘤 锥体束 岛叶 基底节 

分 类 号：R739.4[医药卫生—肿瘤] R445.2[医药卫生—临床医学]