BOLD-fMRI和DTT联合在脑重要功能区及结构回避中的应用

颅内肿瘤切除范围的选择,一直是神经外科最关心的问题。因此在制定颅内肿瘤切除的方案时,不仅要最大限度切除肿瘤,还要注意术中尽量避免脑的重要功能区及相关白质纤维束的损伤,从而提高患者术后的生活质量。但目前大多数手术还是在CT、常规MRI的基础上根据解剖的脑功能区定位制定手术方案,并在术中结合直接皮质刺激技术进行,因此在术前手术方案的制定上具有一定的局限性。随着功能MRI的广泛应用,特别是血氧水平依赖功能磁共振成像与弥散张量成像和纤维束成像的联合应用,为问题的解决提供了非常有价值的方法。由于二者的联合应用不仅能显示出大脑重要功能激活区在病理情况下的移位或改变,同时还能显示肿瘤与重要功能区和白质纤维束结构的关系,具有重要意义。

Combining BOLD-fMRI and DTT for Avoiding the Trauma of the Cerebral Important Function Are-a and the White Matter

The resection area of intracranial tumor has been concerned by the most neurosurgery. There- fore, when formulating the programme of intracranial tumor resection, it is not only to resect the tumor to the greatest extent,but also to avoid the injury of the important function area in the brain and relevant area of the cerebral white matter,and thus to enhance the quality of patients＇ life after surgery. But most of surgery has been formulated on the basis of CT and conventional MRI,and it still relys on the combination of direct cortical stimulation technique and anatomical district in the brain＇s important function area. So the method used in the preoperative surgical planning has some certain limitations. The extensive application of functional magnetic resonance imaging provides a very valuable solution to the problem, especially the synaptic application of the BOLD-fMRI and DTI,DTr. Because this method not only shows shift or change of brain＇s important function area in the pathological circumstances, but also shows the relations among the tumors, the cerebral important function area and the structure of the white matter. In this sense, this method is of great significance.