Role of Diffusion Tensor Imaging in Brain Tumor Surgery.
Role of Diffusion Tensor Imaging in Brain Tumor Surgery.
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DOI：
10.4103/ajns.ajns_226_16
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发表时间：
2018-04-01
期刊：
影响因子：
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通讯作者：
Sinha, Virendra Deo
中科院分区：
文献类型：
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作者：
Dubey, Amitesh;Kataria, Rashim;Sinha, Virendra Deo
目的：评价弥散张量成像（DTI）在脑内肿瘤（胶质瘤和转移瘤）中的作用。术前评估的完整性和位置的白色物质（WM）束和计划的手术走廊，以造成最小的损害，以最小的WM束术后新的神经defictions.MATERIALS和METHODS：共34例患者被纳入本研究。术前对比增强磁共振成像和DTI扫描的患者被考虑在内。术前和术后进行神经系统检查和结果assessed.Results：术前规划的手术走廊和切除范围的计划，使最大可能的切除，可以实现不干扰WM束。DTI显示纤维束受累。21例（61.7%）仅出现纤维束移位，未受肿瘤侵犯。共有11例（32.3%）患者有肿瘤侵犯的管道，而在4例（11.7%）患者的管道中断。术后神经系统检查显示4例（11.7%）患者运动能力下降，3例（8.82%）患者语言功能下降，1例患者记忆力下降。11/18例（61.1%）纤维移位的患者实现了全切除，而5/16例（31.2%）纤维浸润/破坏的患者实现了全切除。这项研究表明，它是一个非常重要的工具，术前计划的手术。WM束的参与是手术结果的强有力预测因素。
OBJECT: The objective is to evaluate the role of diffusion tensor imaging (DTI) in intra-axial brain tumor cases (gliomas and metastasis). To preoperatively assess the integrity and location of white matter (WM) tracts and plan the surgical corridor to cause least damage to the WM tracts with minimum postoperative new neurological deficits.MATERIALS AND METHODS: A total of 34 patients were included in this study. Pre-operative contrast-enhanced magnetic resonance imaging and DTI scans of the patients were taken into consideration. Pre- and post-operative neurological examinations were performed and the outcome was assessed.RESULTS: Preoperative planning of surgical corridor and extent of resection were planned so that maximum possible resection could be achieved without disturbing the WM tracts. DTI indicated the involvement of fiber tracts. A total of 21 (61.7%) patients had a displacement of tracts only and they were not invaded by tumor. A total of 11 (32.3%) patients had an invasion of tracts by the tumor, whereas in 4 (11.7%) patients the tracts were disrupted. Postoperative neurologic examination revealed deterioration of motor power in 4 (11.7%) patients, deterioration of language function in 3 (8.82%) patients, and memory in one patient. Total resection was achieved in 11/18 (61.1%) patients who had displacement of fibers, whereas it was achieved in 5/16 (31.2%) patients when there was infiltration/disruption of tracts.CONCLUSION: DTI provides crucial information regarding the infiltration of the tract and their displaced course due to the tumor. This study indicates that it is a very important tool for the preoperative planning of surgery. The involvement of WM tracts is a strong predictor of the surgical outcome.