核磁共振弥散张量成像技术与血氧水平依赖成像磁共振技术融合神经导航技术在脑肿瘤手术的临床应用  

Clinical application of diffusion tensor imaging technoloy of magnetic resonance imaging and blood oxygen level dependent magnetic resonance imaging combined with neuronavigation technoloy in brain tumor surgery

作　　者：孙永谋 戴如飞 魏赫 周波涛 Sun Yongmou;Dai Rufei;Wei He;Zhou Botao(Department of neurosurgery,general hospital of X uzhou Mining Group,Xuzhou,Jiangsu,221000,China)

机构地区：[1]徐州矿务集团总医院神经外科,江苏徐州221000

出　　处：《齐齐哈尔医学院学报》2022年第4期369-372,共4页Journal of Qiqihar Medical University

摘　　要：目的探索核磁共振弥散张量成像技术(DTI)与血氧水平依赖成像磁共振技术(BOLD-fMRI)联合神经导航技术在脑肿瘤手术中的应用价值。方法选择2019年7月—2020年7月本院神经外科收治的脑肿瘤患者42例作为研究对象,依照术前是否行DTI与BOLD-fMRI检查及术中是否融合神经导航技术的手术策略分为显微组(无DTI无导航)和融合组(融合DTI与BOLD-fMRI的神经导航组)两组,每组各21例。显微组在显微镜下直接切除肿瘤,融合组在显微镜下同时应用已经融合DTI与BOLD-fMRI的神经导航技术辅助下切除肿瘤;根据术后MRI结果对比分析两组患者的手术切除率、症状好转率。结果SimpsonⅠ级切除率显微组为52.3%,低于融合组的76.2%(χ^(2)=7.785,P<0.05);术后三个月时症状好转率融合组为62.0%,高于显微组的33.3%(P<0.05)。结论DTI、BOLD-fMRI及神经导航三者融合的多模态技术具有术前优化手术方案,术中提高肿瘤切除程度,减少纤维束损伤,术后预测并发症及临床功能障碍等优点,更符合现代的神经外科微创、安全手术理念,将在神经外科领域发挥越来越重要的作用。Objective To explore the application value of diffusion tensor imaging(DTI) of magnetic resonance imaging and blood oxygen level dependent imaging(BOLD fMRI) combined with neuronavigation in brain tumor surgery.Methods 42 patients suffer with brain tumors, those were treated in neurosurgery department of our hospital from July 2019 to July 2020, were selected as the research objects. According to the surgical strategy of whether DTI and BOLD fMRI were performed before operation and whether neuronavigation technology was fused during operation, they were randomly divided into two groups: microscope group(no DTI and no navigation) and fusion group(neuronavigation group fused with DTI and BOLD fMRI), with 21 cases in each group. In the microscopical group, the tumor was directly removed under the microscope, and in the fusion group, the tumor was removed under the microscope with the help of neuronavigation technology that has fused with DTI and BOLD fMRI. According to the postoperative MRI results, the surgical resection rate and symptom improvement rate of the two groups were compared and analyzed.Results Simpson Ⅰ resection rate in microscope group was 52.3%, it was lower than 76.2% in fusion group(χ^(2)=7.785,P<0.05). Three months after operation, the improvement rate of symptoms in fusion group was 62.0%, which was higher than 33.3% in microscope group(P<0.05).Conclusions The multimodal technology of DTI, BOLD fMRI and neuronavigation has the advantages of optimizing the surgical scheme before operation, improving the degree of tumor resection and reducing fiber bundle injury during operation, predicting postoperative complications and clinical dysfunction. It is more in line with the modern concept of minimally invasive and safe surgery in neurosurgery, and will play a more and more important role in the field of neurosurgery.

关 键 词：DTI 神经导航 脑肿瘤 纤维束 

分 类 号：R739.41[医药卫生—肿瘤]