fMRI和DTI在功能区胶质瘤手术中的应用价值  

Retrospective analysis of the application value of fMRI and DTI in functional glioma surgery

作　　者：倪卫娟 王超 倪殿军 李归宿 NI Weijuan;WANG Chao;NI Dianjun;LI Guisu(Department of Neurology,Shenzhen Longhua People’s Hospital,Shenzhen 518109,Guangdong Province,China;Department of Neurosurgery,Hangzhou Cancer Hospital,Hangzhou 310000,Zhejiang Province,China;Department of Neurosurgery,Shenzhen Longhua People’s Hospital,Shenzhen 518109,Guangdong Province,China)

机构地区：[1]深圳市龙华区人民医院神经内科,广东深圳518109 [2]杭州市肿瘤医院神经外科,浙江杭州310000 [3]深圳市龙华区人民医院神经外科,广东深圳518109

出　　处：《肿瘤影像学》2021年第2期108-113,共6页Oncoradiology

摘　　要：目的:分析功能磁共振成像(functional magnetic resonance imaging,fMRI)和弥散张量成像(diffusion tensor imaging,DTI)在功能区胶质瘤手术中的指导价值。方法:收集2018年1月—2019年1月于深圳市龙华区人民医院接受手术治疗的50例功能区胶质瘤患者的临床资料,统计患者的DTI、fMRI检查结果和手术结果。结果:高级别胶质瘤的部分各向异性(fractional anisotropy,FA)值和表观扩散系数(apparent diffusion coefficient,ADC)值与低级别胶质瘤相比有差异(t=9.128、8.535,P<0.05)。高级别胶质瘤的纤维束破坏形态发生率明显高于低级别胶质瘤(χ~2=4.393,P<0.05),纤维束移位率明显低于低级别胶质瘤(χ~2=4.462,P<0.05)。41例(82.00%)患者的肿瘤病灶完全切除,高级别胶质瘤患者的完全切除率和生存率均明显低于低级别胶质瘤(χ~2=5.378,P<0.05),复发率高于低级别胶质瘤(χ~2=4.303,P<0.05)。不同级别胶质瘤患者手术后的生存质量评分均明显高于手术前,且低级别胶质瘤患者术后的生存质量评分高于高级别胶质瘤(t=10.812、15.224、19.485,P<0.05)。结论:术前fMRI联合DTI技术进行功能区胶质瘤分级,对提高肿瘤病灶的完全切除率,降低死亡率和复发率有重要意义。Objective:To retrospectively analyze the guiding value of functional magnetic resonance imaging(fMRI)and diffusion tensor imaging(DTI)in functional glioma surgery.Methods:The clinical data of 50 patients with functional glioma who underwent surgical treatment in Shenzhen Longhua People’s Hospital from January 2018 to January 2019 were collected for retrospective analysis,and the DTI,fMRI examination results and surgical results of the patients were collected.Results:The fractional anisotropy(FA)and apparent diffusion coefficient(ADC)values of high-grade gliomas were different from those of low-grade gliomas(t=9.128,8.535,P<0.05).The incidence of fiber bundle destruction in high-grade gliomas was significantly higher than that of low-grade gliomas gliomas(χ2=4.393,P<0.05),and the fiber bundle displacement rate was significantly lower than that of low-grade glioma(χ2=4.462,P<0.05).41 patients(82.00%)had complete resection of tumor lesions.The complete resection rate and survival rate of patients with high-grade glioma were significantly lower than that of low-grade glioma(χ2=5.378,P<0.05),and the recurrence rate was higher than that of low-grade glioma(χ2=4.303,P<0.05).The quality of life scores of patients with different grades of glioma after surgery were significantly higher than those before surgery,and the quality of life scores of patients with low-grade gliomas were higher than those of high-grade gliomas(t=10.812,15.224,19.485,P<0.05).Conclusion:Preoperative fMRI combined with DTI technology for grading functional gliomas is of great significance for improving the complete resection rate of tumor lesions and reducing the mortality and recurrence rate.

关 键 词：胶质瘤 功能磁共振成像 弥散张量成像 功能区 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]