磁共振弥散张量示踪用于颈椎管内肿瘤的形态学研究

目的 探讨颈椎管内肿瘤患者颈髓弥散张量纤维束示踪(DTT)的影像特点及其与脊髓功能、预后的关系。方法 选取2014年2月至2015年1月经手术切除的颈椎管内肿瘤24例,在术前3天及术后1个月行颈髓弥散张量成像(DTI)扫描,并通过DTT重建白质纤维束,观察纤维束走行及完整性情况。采用McCormick分级法进行脊髓功能的评估。结果 DTT可清晰显现纤维束的饱满或稀疏情况,完整或中断现象；也可以观察纤维束与肿瘤之间的空间位置关系：纤维束是受肿瘤推压移位还是包绕肿瘤。术前纤维束形态与McCormick分级及预后有关系,纤维束形态完整的患者术前脊髓功能状态及术后1个月时的预后均要显著好于中断型(P<0.05)。结论 DTT能直观显示白质纤维束的形态,并对颈椎管内肿瘤的预后判断具有参考价值。

Magnetic resonance diffusion tensor tracking technique for morphological study of cervical intraspinal tumors

Objective To investigate the imaging character of diffusion tensor tracking (DTT) in patients with cervical intraspinal tumors ,and study its association with spinal cord function and prognosis. Methods The study material included 24 surgically removed cervical intraspinal tumors, obtained from Feb. 2014 to Jan. 2015. Cervical diffusion tensor imaging (DTI) scan was performed in all patients three days preoperatively and one month postoperatively. White matter fiber bundle was reconstructed by DTT for observation on its traveling and integrity. Spinal cord function was assessed by McCormick grading.. Results DTT was able to distinctly show tractography full or sparse, intact or interrupted. Through this technique, spacial relationship(displacement or encasement) between the tumor and fiber bundle could be also observed. Pattern of preoperative tractography correlated with McCormick grading and prognosis of spinal cord function. Preoperative spinal cord function state and prognosis one month postoperatively of patients with intact form in tractography was significantly better than that of interrupted form (P<0.05). Conclusion Form of white matter fiber bundle visualized through DTT can be used to determine the prognosis of cervical intraspinal tumors.