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磁共振弥散张量成像对功能区脑肿瘤手术的参考价值
引用本文:张媛,刘建刚,张世明.磁共振弥散张量成像对功能区脑肿瘤手术的参考价值[J].临床神经外科杂志,2012,9(3):157-159.
作者姓名:张媛  刘建刚  张世明
作者单位:1. 河北大学附属医院放射科, 保定,071000
2. 苏州大学附属第一医院神经外科
摘    要:目的]评价磁共振弥散张量成像(DTI)对功能区脑肿瘤手术的指导意义和应用价值.方法]对25例患者行头部DTI检查,立体显示肿瘤与脑白质纤维束的关系,术前评估,设计手术入路,对所有病例行显微外科肿瘤切除手术治疗.结果]本组脑肿瘤中累及脑白质纤维束区域主要位于锥体束和内囊,其中脑白质纤维束破坏13例,移位12例.肿瘤全切除11例,次全切除14例,无手术死亡.术前存在脑白质纤维束受累所致的神经功能阳性体征者术后改善13例,无变化者10例,加重2例.结论]DTI能够清晰显示脑肿瘤对白质纤维束的累及关系,对神经外科优化手术设计、决定手术切除范围和评估术后神经功能具有指导意义.

关 键 词:磁共振弥散张量成像  白质纤维束  脑肿瘤  功能区  显微手术

Values of diffusion tensor imaging technique in microsurgery of brain tumors in functional region
ZHANG Yuan , LIU Jian-gang , ZHANG Shi-ming.Values of diffusion tensor imaging technique in microsurgery of brain tumors in functional region[J].Journal of Clinical Neurosurgery,2012,9(3):157-159.
Authors:ZHANG Yuan  LIU Jian-gang  ZHANG Shi-ming
Affiliation:. Department of Radiology, the Affiliated Hospital of Hebei University, Baoding 071000, China
Abstract:Objective To evaluate the values of diffusion tensor imaging(DTI) in microsurgery of brain tumors in functional region. Methods 25 patients with brain tumors in functional region were checked by diffusion tensor imaging. The relationship between white matter fiber tracts and brain tumor were analyzed before the operation. The reasonable surgical plain was established according to the information. All patients received microsurgery. Results DTI demonstrated that pyramidal tract and internal capsule were involved. The signs involved in damage to the white matter fiber tracts in 13 cases,and the white matter fiber tracts displacement in 12. Lesions were totally removed in 11 cases and subtotally in 14. There was no operative mortality. Dysfunction before operation improved postoperatively in 13 cases, no change in 10, and aggravation in 2. Conclussion The relationship between white matter fiber tracts and brain tumor is demonstrated clearly by DTI. DTI is valuable to design surgical approach,determine resectable scope and evaluate the prognosis.
Keywords:diffusion tensor imaging  white matter fiber tracts  brain tumor  functional region  microsurgery
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