融合DTI及BOLD成像在脑功能区肿瘤神经导航术中的应用  

Clinical Application of DTI Combined with BOLD-fMRI in Neuronavigation Surgery of Brain Functional Tumors

作　　者：叶新运[1] 蒋秋华[1] 冯秋女[1] 杨瑞金[1] 张震宇[1] 冯开明[1] 唐知己[1] 宋海民[1] 胡坤[1] 张珍华[1] 张金石[1] 

机构地区：[1]赣州市人民医院,江西赣州341000

出　　处：《现代医院》2016年第9期1257-1259,共3页Modern Hospitals

基　　金：江西省卫生计生委科技计划项目(项目编号:20164054)

摘　　要：目的探讨弥散张量成像技术(DTI)融合血氧水平依赖成像技术(BOLD)指导脑功能区肿瘤神经导航手术的临床应用价值。方法我院在2011年12月-2015年12月收治37例涉及运动区的脑肿瘤患者,按随机数字表法将其分为试验组(DTI融合BOLD影像导航)19例及对照组(仅DTI影像导航)18例,两组患者均行脑功能区肿瘤神经导航术,利用SPSS 19.0统计两组患者手术效果及预后情况。结果对照组肿瘤全切率50%低于试验组肿瘤全切率73.68%(P<0.05);对照组术后致残率61.11%高于试验组术后致残率36.84%(P<0.05);预后评估:对照组KPS评分(79.11±13.14)分低于试验组KPS评分(90.00±4.88)分,对照组优良率38.90%低于试验组优良率63.20%(P<0.05)。结论 DTI联合BOLD技术应用于功能区脑肿瘤的导航手术,能更清晰地显示脑功能区的解剖学信息,有利于最佳手术入路及手术方案的设计,对提高肿瘤的全切率及最大限度地保留运动功能具有重要的价值。Objective To explore the clinical application value of diffusion tensor imaging （DTI） fusion blood oxy- gen level dependent imaging （BOLD） to guide the surgical treatment of brain functional areas. Methods 37 cases involving motor areas of the brain tumor patients in our hospital from December 2011 to 2015 December were assigned into for test group by DTI fusion BOLD imaging navigation （n = 19） and control group by only DTI navigation （n = 18） by the random digital number table. The patients in the two groups underwent brain tumor neuronavigation surgery. SPSS - aided statistical treat- ment was performed. Results The tumor complete resection rates in the control group and the trial group was 50% and 73.68% （P 〈0. 05）. The postoperative morbidities of the control group and the trial group were 61.11% and 36. 84%, re- spectively （ P 〈 0. 05 ）. For prognosis assessment, KPS score of the control group and the trial group KPS score was （79. 11 ± 13. 14） and （90. 00± 4. 88）, respectively. The excellent outcome rates in the control group and the trail group were 38.90% and 63.20% , respectively （ P 〈 0. 05 ）. Conclusion DTI and BOLD fMRI technology application in the functional area of the brain tumor surgery navigation, can more clearly show the brain functional area, conducive to the best surgical approach and operative scheme design. It is of value for the improvement of total tumor resection rate and the maxi- mum retention of motor function.

关 键 词：弥散张量成像 脑肿瘤 功能区 神经导航 

分 类 号：R651.11[医药卫生—外科学]