弥散张量成像对颅脑肿瘤与相邻脑白质纤维束解剖关系的评价

目的:评价弥散张量成像技术显示颅脑肿瘤与相邻脑白质纤维束解剖关系的价值。材料和方法:对5例正常志愿者及29例幕上星形细胞瘤及脑膜瘤进行弥散张量成像,在弥散各向异性图、彩色张量图及脑白质纤维束图上分析肿瘤与相邻脑白质纤维束的解剖关系,并对患者术前、术后的临床症状进行评价。结果:(1)9例脑膜瘤及11例Ⅰ-Ⅱ级星形细胞瘤推移相邻脑白质纤维束,患者术后临床症状明显改善。(2)6例Ⅲ-Ⅳ级星形细胞瘤及3例Ⅰ-Ⅱ级星形细胞瘤浸润、破坏相邻脑白质纤维束,患者术后的临床症状未明显改善。结论:弥散张量成像技术在显示颅脑肿瘤与相邻脑内主要白质纤维束的解剖关系方面具有重要价值,对神经外科术前治疗方案的确定具有重要指导作用。

The Evaluation of Relationships between Intracranial Tumors and Neighboring Fibers by Using Diffusion Tensor Imaging

Purpose: To evaluate the usefulness of diffusion tensor imaging(DTI) in demonstrating relationship between intracranial tumors and neighboring fibers.Materials and Methods: Diffusion tensor imaging was performed on 5 normal volunteers and 29 cases of supratentorial astrocytic tumors and meningiomas.Anatomic relationship between intracranial tumors and neighboring fibers was analysed on fractional anisotropy imaging,color tensor imaging and tractographic imaging.All patients symptoms were evaluated preoperative and postoperative respectively.Results:(1) When fibers were displaced by tumors,including 9 cases of meningiomas and 11 cases of low grade astrocytic tumors,the patients has definite improvement in symptoms.(2) When fibers were destroyed by tumors,including 6 cases of high grade astrocytic tumors and 3 cases of low grade astrocytic tumors,the patients has not definite improvement in symptoms.Conclusion: Diffusion tensor imaging plays an important role in demonstrating relationship between intracranial tumors and neighboring fibers,which is of importance to guide neurosurgical preoperative planning.