弥散张量联合荧光素钠指导功能区胶质瘤手术治疗价值  

Clinic value of diffusion tensor imaging and fluorescein sodium in operation of gliomas in or near the eloquent region

作　　者：张海旺[1] 张苓[1] 陈礼刚 彭里磊[1] 周杰[1] 陆笑非[2] 酉建[1] 刘洛同[1] 明扬[1] 

机构地区：[1]泸州医学院附属医院神经外科,四川泸州646000 [2]泸州医学院附属医院影像科,四川泸州646000

出　　处：《第三军医大学学报》2014年第4期406-409,共4页Journal of Third Military Medical University

基　　金：泸州市科技局重点课题(12029);泸州医学院附属医院人才基金(12299)~~

摘　　要：目的探讨术前弥散张量成像(diffusion tensor imaging,DTI)联合术中荧光素钠显像指导功能区胶质瘤手术治疗价值。方法对2010年2月至2011年6月在我院采用DTI联合荧光素钠手术和传统手术治疗且获得随访月份≤24个月的功能区胶质瘤患者的病历资料进行回顾性分析,DTI联合荧光素钠组21例术前均行增强MRI、DTI联合术中应用荧光素钠显像,传统组22例术前均行增强MRI。术后第1天均行增强MRI检查患者肿瘤切除程度、术后2周用Karnofsky评分评价患者生存质量、术后均行同步放化疗3个月以上,观察患者术后2年的生存率。结果术后增强MRI示观察组在肿瘤的全切率上显著高于对照组,术后2周Karnofsky评分观察组显著高于对照组,观察组术后2年的生存率显著高于对照组,差异有统计学意义(P<0.05)。结论弥散张量成像联合荧光素钠显像技术能确保术中最低程度破坏功能纤维束而最大程度切除肿瘤,提高患者生存质量和生存时间。Objective To assess the clinic value of diffusion tensor imaging （DTI） combined with fluorescein sodium in guiding resection of gliomas in or near the eloquent region.Methods The data of patients with gliomas in or near the eloquent region treated in our hospital from February 2010 to June 2011 were retrospectively investigated. These patients followed up for at most 24 months were divided into 2 groups, an observation group and a control group. The 21 patients in the observation group underwent enhanced MRI and DTI before operation and were injected with fluorescein sodium during operation. The 22 patients in the control group only underwent enhanced MRI before operation. All patients were subjected to enhanced MRI to assess the degree of resection one day after the operation. Karnofsky score was used to evaluate all patients’ quality of life two weeks after the operation. All patients underwent chemoradiotherapy after operation for more than 3 months. Two-year survival rate of the patients was observed.Results The total tumor removal rate evaluated by enhanced MRI after operation, Karnofsky score in 2 weeks after operation and two-year survival rate in the observation group were all higher than those in the control group, with statistically significant differences （P〈0.05）.Conclusion The application of DTI combined with fluorescein sodium helps achieve maximal glioma resection in or near the eloquent region and minimal damage of functional fiber bundles, improving patients’ quality of life and survival time.

关 键 词：胶质瘤 荧光素钠 弥散张量成像 

分 类 号：R730.264[医药卫生—肿瘤] R730.56[医药卫生—临床医学]