Preoperative and postoperative high angular resolution diffusion imaging tractography of cerebellar pathways in posterior fossa tumors.
Preoperative and postoperative high angular resolution diffusion imaging tractography of cerebellar pathways in posterior fossa tumors.
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DOI：
10.1002/ca.23914
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发表时间：
2022-11
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本研究旨在利用高角分辨率扩散磁共振成像 (HARDI) 纤维束成像来绘制与后颅窝肿瘤（幕下肿瘤）相关的小脑通路，并确定其是否可用于术前和术后评估。使用来自 30 名后颅窝肿瘤患者（年龄 2-16 岁）（17 名低级别，13 名高级别）和 30 名年龄性别匹配的健康对照的回顾性数据。在 3 特斯拉扫描仪上收集结构和扩散加权图像。使用 Diffusion Toolkit 软件、Q-ball 模型、FACT 算法和 45 度的角度阈值进行纤维束成像。放置手动评估的感兴趣区域，以确定术前、术后和健康对照组穿过小脑上脚、内侧脚和下脚的重建纤维通路。获得并分析了分数各向异性 (FA)、表观扩散系数 (ADC) 和轨迹体积测量值。两组术前/术后、术前/对照和术后/对照的纤维束体积比较均存在统计学上的显着差异。通路的移位和破坏似乎与肿瘤的严重程度有关。术后通路的丧失与手术期间由于肿瘤浸润而选择性切除有关。低级别肿瘤中 FA 没有差异，但 ADC 显着升高，高级别肿瘤中 FA 和 ADC 没有差异。通过 HARDI 纤维束成像成功评估了后颅窝肿瘤对小脑脚和重建通路的影响。该技术似乎不仅可用于术前评估，还可用于术后评估。
This study aimed to utilize high angular resolution diffusion magnetic resonance imaging (HARDI) tractography in the mapping of the pathways of the cerebellum associated with posterior fossa tumors (infratentorial neoplasms) and to determine whether it is useful for pre and postoperative evaluation. Retrospective data from 30 patients (age 2–16 yr) with posterior fossa tumor (17 low grade, 13 high grade) and 30 age-sex-matched healthy controls were used. Structural and diffusion-weighted images were collected at a 3-tesla scanner. Tractography was performed using Diffusion Toolkit software, Q-ball model, FACT algorithm, and angle threshold of 45 degrees. Manually assessed regions of interest were placed to identify reconstructed fiber pathways passing through the superior, medial, and inferior cerebellar peduncles for the preoperative, postoperative, and healthy control groups. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), and track volume measures were obtained and analyzed. Statistically significant differences were found between the preop/postop, preop/control, and postop/control comparisons for the volume of the tracts in both groups. Displacement and disruption of the pathways seemed to differ in relation to the severity of the tumor. The loss of pathways after the operation was associated with selective resection during surgery due to tumor infiltration. There were no FA differences but significantly higher ADC in low-grade tumors, and no difference in both FA and ADC in high-grade tumors. The effects of posterior fossa tumors on cerebellar peduncles and reconstructed pathways were successfully evaluated by HARDI tractography. The technique appears to be useful not only for preoperative but also for postoperative evaluation.