摘要： 目的 应用弥散张量成像（DTI）技术检测颅内肿瘤与周围脑白质神经纤维束的解剖关系，探讨其对手术的指导作用及临床应用。方法 采用Siemens 3.0T磁共振成像（MRI）系统，对79例颅内幕上肿瘤患者进行常规MRI及DTI扫描，应用DSI-studio软件进行后处理成像，分析颅内肿瘤与周围脑白质神经纤维束间的解剖关系。分别获取肿瘤脑白质纤维区、肿瘤周围的水肿区、肿瘤周围脑白质纤维区、肿瘤对侧正常脑白质纤维区的各向异性（FA）分数值。结果 所有患者的脑白质神经纤维束均有不同程度移位；肿瘤周围脑白质神经纤维束呈浸润或破坏者，肿瘤病理结果恶性程度高；脑白质神经纤维束破坏范围及程度与肿瘤的良恶性程度有关。在肿瘤脑白质纤维区，高级别胶质瘤FA值与低级别胶质瘤有统计学差异（P<0.05）。在肿瘤周围水肿区、肿瘤周围脑白质纤维区、肿瘤对侧正常脑白质纤维区，FA值均无统计学差异（P>0.05）。结论 DTI能在活体无创、直观地显示颅内肿瘤与周围脑白质神经纤维束的解剖关系，对神经外科医生为颅内肿瘤患者术前制定手术方案、预测手术风险具有重要指导意义。

弥散张量成像在检测颅内肿瘤与周围脑白质神经纤维束解剖关系中的临床应用价值

李虹, 韩奕勃, 呼虹宇, 李婷, 王帅, 王义宝, 仇波

中国医科大学附属第一医院神经外科, 沈阳 110001

收稿日期:2020-01-18出版日期:2020-12-30发布日期:2020-12-09
通讯作者:仇波E-mail:bo_qiu@msn.com
作者简介:李虹(1992-),女,硕士研究生.



关键词: 弥散张量成像, 脑白质神经纤维束, 颅内肿瘤, 胶质瘤, 神经影像学
Abstract: Objective to detect the anatomical relationship between intracranial tumors and the white matter nerve fiber tracts around tumors with diffusion tensor imaging (DTI),and explore the guiding role and clinical application of DTI in surgery. Methods A magnetic resonance imaging (MRI) system was used to scan 79 patients with intracranial supratentorial tumors using conventional MRI and DTI. DSI-studio software was used to process and display the anatomical relationship between tumors and white matter fiber tracts,as well as to measure the fractional anisotropy (FA) value of the designated area. Results The white nerve fiber tracts of all patients were shifted or destroyed to varying degrees,depending on whether the tumors were benign or malignant according to pathological results. The mean FA value of high-grade glioma (0.236±0.029) was significantly less than that of high-grade glioma (0.185±0.026,P<0.05). Conclusion DTI can non-invasively and intuitively display the anatomical relationship between tumors and white fiber tracts,allowing neurosurgeons to formulate surgical plans and accurately predict surgical risks.
Key words: diffusion tensor imaging, white matter nerve fiber bundles, intracranial tumors, gliomas, neuroimaging
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