低级别胶质瘤累及区对运动功能影响的影象学定量分析研究  

The relationship between tumor location of low-grade gliomas and motor dysfunction： a neuroimaging analysis

作　　者：张檀[1] 王引言[2] 李明泱 丁浩然[3] 李少武[2] 江涛[2] 王磊[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,100050 [2]首都医科大学北京市神经外科研究所 [3]北京三博脑科医院神经外科

出　　处：《中华神经外科杂志》2014年第9期908-911,共4页Chinese Journal of Neurosurgery

基　　金：国家973重点基础研究发展计划资助项目（2011CB707804）

摘　　要：目的 通过基于体素的影像学定量分析探讨累及运动区的低级别胶质瘤与肌力改变的关系,在体素水平计算肿瘤累及引起肌力改变的风险值,绘制肌力变化风险图.方法 将52例低级别胶质瘤患者的肿瘤占位区域分别标记并配准到MNI坐标系标准脑图谱上,在标准空间内叠加所有患者的肿瘤占位影像.计算每个体素有肌力变化的病例数占总叠加层数的百分比,并通过色阶将风险率显示在标准脑图谱上.结果 得到基于体素的低级别胶质瘤运动区占位与肌力改变发生率风险图谱,定量显示出运动区及其周围低级别胶质瘤占位对肌力影响的风险值,M1区手结区的外侧及次级运动区风险值多处在30％左右,而从M1区手结区向内侧风险值逐渐提高,从40％逐渐增至80％,前内侧最高,达80％以上.并依据风险值的差异将手结区层面运动区分为三个风险级别不同的区域.结论 基于影像学分析得到运动中枢风险图谱能够有效的反应低级别胶质瘤运动区占位与肌力改变的相关性,预测性的评估运动区肿瘤性损害对患者肌力改变情况.Objective To explore the relationship between tumor location of low grade gliomas in motor area and motor dysfunction by drawing the dyskinesia risk map.Methods All of images of patient were registered to T1 weighted brain atlas （MNI152; Montreal Neurological Institute）,calculating the overlay layer of motor dysfunction account for the total number of overlay for each voxel,in order to draw the dyskinesia risk map.Results The dyskinesia risk map was acquired by quantitive neuroimage analysis.The medial part of the hand knot had more effects on motor strength than the lateral part.The risk values of the lateral part of hand knot and secondary motor areas were lowest.From the lateral part to the medial,the risk values increased gradually from 40％ to 80％.Conclusions The dyskinesia risk map could demonstrate the relationship between low grade gliomas in motor area and motor dysfunction effectively,and predictively evaluate the motor dysfunction.

关 键 词：低级别胶质瘤 运动区 肌力 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤]