结合fMRI与DTI在脑胶质瘤诊治中的初步应用

邱明国; 王健; 谢兵; 巫北海; 李七渝; 刘广久; 张绍祥

中国临床医学影像杂志 ›› 2009, Vol. 20 ›› Issue (9) : 668-672.

论著

结合fMRI与DTI在脑胶质瘤诊治中的初步应用

邱明国1，王健2，谢兵2，巫北海2，李七渝1，刘广久1，张绍祥1

作者信息 +

Applied study of functional MRI and DTI in cerebral gliomas

QIU Ming-guo1, WANG Jian2, XIE Bing2, WU Bei-hai2, LI Qi-yu1, LIU Guang-jiu1, ZHANG Shao-xiang1

Author information +

文章历史 +

摘要

目的：探讨DTI在脑胶质瘤定性、定级诊断中的作用，并尝试联合应用fMRI与DTI技术进行脑肿瘤术前定位及术中导航。方法：对18例脑胶质瘤患者进行常规T1WI、T2WI扫描及DTI、fMRI功能成像，测量肿瘤的实质部分、坏死或囊变区以及瘤周水肿区域的ADC值、FA值等参数。采用SPM软件对fMRI图像数据进行处理和统计分析，观察运动功能激活区、重要白质纤维束与颅内肿瘤病灶之间的相互关系。结果：高级别胶质瘤实体部分ADC值明显低于低级别胶质瘤，而FA值明显高于低级别胶质瘤，两者之间有显著性差异。高、低级别胶质瘤实质部分ADC值的分界点为1.21×10-3mm2/s，FA值分界点为0.17。联合应用fMRI与DTI可全面观察脑运动或视觉等重要功能激活区、重要白质纤维束与颅内肿瘤病灶之间的相互关系。结论：应用DTI可以在术前对胶质瘤进行分级，将fMRI与DTI功能影像应用于脑肿瘤导航手术可为术前计划提供必要信息，在术中避免损伤脑功能区及锥体束等重要结构，为手术提供双重保障。

Abstract

Objective: To evaluate the usefulness of ADC and FA value in differentiating solid tumor, necrotic region, edema region and in grading the malignancy of cerebral gliomas, and try to evaluate the combined use of fMRI and DTI in presurgical planning and surgical navigation. Methods: Eighteen patients with glioma were imaged at 1.5T using T1-weighted, T2-weighted, contrast T1-weighted, fMRI and DTI sequences. The ADC and FA value were measured in solid tumor, necrotic region and edema region. Brain activity was measured with SPM software, and the functional MRI images were integrated into the T1-weighted and FA maps and transferred to MRI-based neuronavigational system. Results: The ADC values of the solid portion of high-grade gliomas were significantly lower than those of low-grade gliomas. The ADC threshold between low grade and high grade gliomas was 1.21×10-3mm2/s. The FA values of the solid portion of high-grade gliomas were significantly higher than those of low-grade gliomas. The FA threshold between low grade and high-grade gliomas was 0.17. Combined fMRI and DTI can establish spatial relationships between eloquent white matter, motor and vision functional area and the tumor borders, and provide a better estimation of the proximity of tumor borders to eloquent brain systems. Conclusion: DTI can distinguish between high-grade and low-grade gliomas, combined fMRI and DTI can provide information essential to preoperative planning, avoiding injury to the brain functional area and pyramidal tract.

导出引用

邱明国;王健;谢兵;巫北海;李七渝;刘广久;张绍祥. 结合fMRI与DTI在脑胶质瘤诊治中的初步应用[J]. 中国临床医学影像杂志. 2009, 20(9): 668-672

QIU Ming-guo;WANG Jian;XIE Bing;WU Bei-hai;LI Qi-yu;LIU Guang-jiu;ZHANG Shao-xiang. Applied study of functional MRI and DTI in cerebral gliomas[J]. Journal of China Clinic Medical Imaging. 2009, 20(9): 668-672

中图分类号： Ｒ739.41 Ｒ730.264 Ｒ445.2