摘要
目的探讨弥散张量纤维束成像(DTT)在指导脑深部肿瘤手术中的价值。方法对25例脑深部肿瘤病人(实验组)利用DTT对肿瘤与毗邻纤维束的位置关系及纤维束状态进行评估,结合常规MRI设计手术入路及切除范围;另24例病人(对照组)仅根据常规MRI设计手术入路及切除范围。对两组肿瘤的全切除率及术后致残率进行对比分析。结果实验组中,肿瘤全切除18例,部分切除7例;术后出现神经功能缺损或障碍加重3例。对照组中,肿瘤全切除13例,部分切除11例;术后出现神经功能缺损或障碍加重11例。两组肿瘤全切除率差异无统计学意义(P>0.05),而对照组术后致残率明显高于实验组(P<0.01)。结论DTT能清楚显示脑深部肿瘤与毗邻纤维束的位置关系及纤维束被侵犯的程度,有助于设计合理手术入路及切除范围,对最大程度切除肿瘤同时减少术后功能缺损具有重要作用。
Objective To investigate the guidance value of diffusion tensor imaging-based fiber tracking （DTT） for resection of deep brain tumors. Methods In experimental group （n=25）, DTT was used to evaluate the adjacent relationship between the brain tumor and white matter fiber tracts, and also the functional status of the fiber tracts. The surgical approach and resection extent were designed according to the results of routine MRI and DTT. However, in control group （n=24）, the surgical approach and resection extent were only assisted by routine MRI information. The complete resection rate and disability rate were compared between the two groups. Results In experimental group, complete resection were achieved in 18 cases, while 13 cases in the control group. Tumors were partly resected in 7 cases compared to 11 cases in the control group. Three patients had new post-operative neurological deficit or the original symptoms aggravated in the experimental group compared with 11 in control group. There were no significant differences in the complete resection rate between the two groups （P〉0.05）. However, the post-operative disability rate was significantly higher compared with the control group （P 〈0.01）. Conclusion DTT can clearly display the relationship between the tumor and adjacent fiber tracts and the extent of tumor invasion of fiber tracts, thus being helpful to design a reasonable surgical plan for maximizing tumor resection and minimizing neurological deficits.
出处
《中国微侵袭神经外科杂志》
CAS
北大核心
2009年第7期292-294,共3页
Chinese Journal of Minimally Invasive Neurosurgery
基金
安徽省科技攻关项目(编号:07010302202)
关键词
磁共振成像
弥散
纤维束成像
脑肿瘤
显微外科手术
diffusion magnetic tensor imaging
fiber tracking
brain neoplasms
microsurgery
