胶质瘤侵犯中央前回对大脑半球激活斑的影响:一项任务态磁共振研究  

Effect of Diffuse Glioma with Precentral Gyrus Invasion on Interhemispheric Brain Activation:A Task-based FMRI Study

作　　者：曾善美 赵静[1] 初建平[1] ZENG Shanmei;ZHAO Jing;CHU Jianping(Department of Radiology,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院放射科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2024年第1期100-107,共8页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(82172015,82202217);广东省基与应用基础研究基金(2022A1515011264,2021A1515012279);广州市科技计划项目(202201011244)。

摘　　要：【目的】探讨在术前任务态功能磁共振(T-fMRI)中,胶质瘤侵犯中央前回对双侧大脑半球激活斑的影响。【方法】将56例接受了术前任务态磁共振扫描的胶质瘤患者分为中央前回侵犯组(PGI,n=21)和中央前回无侵犯组(PGNI,n=35)。我们设定了三个不同的体素水平上的统计阈值(P值:P1,10^(-4);P2,10^(-6);P3,10^(-8)),并获得相应统计水平的大脑激活图(V1,V2和V3)。分别计算双侧大脑半球间(瘤侧/对侧:IAVR)和双侧中央前回间的激活斑体积比值(瘤侧/对侧:PAVR)。计算位于不同统计阈值区间的激活斑体积(△V1=V1-V2;△V2=V2-V3),并进一步比较它们在双侧大脑半球间的比值[△Vn(瘤侧)/△Vn'(对侧),n=1,2]。此外,我们还分析了肿瘤特征与IAVR和PAVR间的关系。【结果】在相对较低的统计阈值水平中(P1和P2),相较于PGNI组,PGI组的IAVR和PAVR明显减低(P<0.05),但在较严格的统计阈值中(P3),这两组间则无明显差异。相比PGNI组,PGI组的△V1/△V1’明显减低(P=0.02),但△V2/△V2’在两组间没有差异。此外,在PGI组,PAVR与肿瘤大小呈负相关(P=0.043),并且肿瘤距手节区的距离与IAVR和PAVR呈正相关(P<0.05)。【结论】相比胶质瘤未侵犯功能区,在T-fMRI中,侵犯功能区会更容易影响肿瘤同侧脑半球中较低统计阈值的激活斑,造成双侧大脑半球间激活斑不对称性,但这种影响在更严格的统计阈值中没有出现。选取多个统计阈值来分析胶质瘤术前T-fMRI的激活斑结果是十分必要的。【Objectives】To explore the effect of diffuse glioma with precentral-gyrus invasion on fMRI activation maps by grasping T-fMRI.【Methods】A total of 56 diffuse glioma patients were divided into precentral-gyrus invasion(PGI:n=21)and precentral-gyrus non-invasion(PGNI:n=35)groups.Three statistical thresholds(P value:10^(-4),P1;10^(-6),P2;10^(-8),P3)were set to obtain the activation maps accordingly(V1,V2 and V3).The interhemispheric and bilateral precentral gyrus activation volumes ratios(IAVR and PAVR)were calculated,respectively.The activation volumes[△V1=V1-V2;△V2=V2-V3;△Vn(ipsilateral)/△Vn’(contralateral),n=1,2]within two statistical thresholds and the corresponding interhemispheric ratio was further compared.In addition,the associations of tumor characteristics with IAVR and PAVR were analyzed.【Results】Compared with PGNI,PGI showed significantly decreased IAVR at p1,and the same trends of PAVR in PGI at P1 and P2(P<0.05).However,neither IAVR nor PAVR showed significant differences at P3.PGI showed significantly lower ratios of△V1/△V1’than PGNI(P=0.02),except for△V2/△V2’.Additionally,within PGI,PAVR was negatively correlated with tumor volume(P=0.043),and the distance from the tumor to the hand�knob was positively correlated with the IAVR and PAVR(P<0.05).【Conclusion】Diffuse glioma invading eloquent areas tended to affect interhemispheric asymmetry of activation at relatively lower statistical thresholds than diffuse glioma without invasion,rather than stricter statistical thresholds.Multiple ranges of statistical thresholds were recommended to analyze T-fMRI.

关 键 词：胶质瘤 大脑半球 中央前回 激活斑 功能磁共振 

分 类 号：R739.41[医药卫生—肿瘤]