弥散张量成像对丘脑胶质瘤手术的临床意义  

Clinical significance of diffusion tensor imaging in resection of thalamic gliomas

作　　者：周德祥[1] 林晓风[1] 詹升全[1] 周东[1] 陈光忠[1] 王鹏[1] 郭文龙[1] 彭超[1] 

机构地区：[1]广东省人民医院广东省医学科学院神经外科,广州510080

出　　处：《中国微侵袭神经外科杂志》2015年第12期539-541,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：广东省科技计划项目资助(编号:2012B031800165);国家自然科学基金青年基金(编号:81201995)

摘　　要：目的探讨弥散张量成像(DTI)对丘脑胶质瘤手术切除的指导意义。方法回顾性分析42例丘脑胶质瘤病例资料。DTI组(术前行MRI+DTI检查)22例,内侧前方入路8例,内侧后方入路3例,前外侧入路2例,后外侧入路8例,后上方入路1例。对照组20例(术前仅行MRI检查),内侧入路11例,前外侧入路1例,后外侧入路8例。比较两组肿瘤全切率及术后4周KPS评分差异。结果对照组肿瘤全切除13例,次全切除6例,部分切除1例,全切率65.0%。DTI组肿瘤全切除13例,次全切除8例,部分切除1例,全切率59.1%。两组全切率比较,无统计学差异(P>0.05)。术后4周KPS评分对照组为77.67±19.09分,DTI组为87.29±14.84分,两组KPS评分比较,差异具有统计学意义(P<0.05,F=0.269)。结论术前DTI对丘脑胶质瘤制定手术方案有重要临床意义。Objective To explore the clinical significance of diffusion tensor imaging（DTI） in thalamic glioma resection. Methods The clinical data of 42 patients with thalamic gliomas were analyzed retrospectively. There were 22 patients who received preoperative MRI and DTI scanning as the DTI group, among them the operation was performed via medial anterior approach in 8 patients, medial posterior approach in 3, anterolateral approach in 2, posterolateral approach in 8, posterior upward approach in 1. There were 20 patients who received preoperative MRI scanning alone as the control group, and the operation was performed via medial approach in 11 patients, anterolateral approach in 1, posterolateral approach in 8. The total resection rate and the KPS scores 4 weeks after operation were compared between two groups. Results In the control group, total tumor resection was achieved in 13 patients, subtotal resection in 6 and part resection in 1, with a total resection rate of 65.0%. While in the DTI Group, the total resection was achieved in 13 patients, subtotal resection in 8 and part resection in 1, with a total resection rate of 59.1%. There was no significant difference in the rate of total resection between the two groups（P 〉0.05）. The KPS scores of the control group and the DTI group was 77.67 ± 19.09 and 87.29 ± 14.84 respectively. There was a significant difference between the two groups（P〈 0.05, F = 0.269）. Conclusion Preoperative DTI is benefit for surgical planning of thalamic gliomas.

关 键 词：神经胶质瘤 丘脑 弥散张量成像 

分 类 号：R739.4[医药卫生—肿瘤]