低磁场术中磁共振导航的融合弥散张量成像功能研究

目的:探讨低磁场术中磁共振成像(iMRI)导航手术利用弥散张量成像(DTI)的可能性和应用价值。方法:19例涉及锥体束的脑肿瘤患者,应用多影像融合技术将术前DTI与iMRI影像融合指导手术,术中利用非刚体配准计算法和手动点配准融合技术把修正的DTI逐层与更新的iMRI影像融合,并导航手术。术后随访肢体运动功能。结果:成功获得DTI变形预测结果,肿瘤全切除率63.2%,次全切除率15.8%,肢体运动较术前好转或维持术前症状者84.2%。结论:iMRI与DTI融合导航手术可实时提供病灶与邻近锥体束间三维可视化解剖信息,提高肿瘤切除率,降低术后致残率。

The Integration of DTI and iMRI in Brain Surgery Involving Pyramidal Tracts

Aim:To evaluate the likelihood and role of integration of diffusion tensor imaging (DTI) and intraoperative MRI (iMRI) of PoleStar N-20 in brain surgery involving pyramidal tracts.Methods:The preoperative DTI was merged into iMRI for neuronavigation by using manual point merge technique with non-rigid calculation in 19 patients with brain surgery involving pyramidal tracts. The relationship between the tumors and adjacent pyramidal tracts were segmented and reconstructed for three-dimensional visualization. The motor function of extremities was examined before and after operation. Results:The prediction and merge of DTI with iMRI were of success. The lesions were completely resected in 12 cases (63.2%), subtotal in 15.8%. Postoperative neurological status was improved and stable in 84.2% cases. Conclusion: The integration of DTI and iMRI is feasible in neuronavigation surgery of brain surgery involving pyramidal tracts.