Assessing Region of Interest Schemes for the Corticospinal Tract in Patients With Brain Tumors.
Assessing Region of Interest Schemes for the Corticospinal Tract in Patients With Brain Tumors.
复制标题
评估脑肿瘤患者皮质脊髓束的感兴趣区域方案
DOI：
10.1097/md.0000000000003189
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发表时间：
2016-03
期刊：
影响因子：
1.6
通讯作者：
Zhang M
中科院分区：
文献类型：
--
作者：
Niu C;Liu X;Yang Y;Zhang K;Min Z;Wang M;Li W;Guo L;Lin P;Zhang M
摘要弥散张量成像（DTI）和弥散张量纤维束成像（DTT）技术被广泛应用于确定皮质脊髓束（CST）的白色通路，作为术前计划的一部分。然而，脑肿瘤患者的占位效应往往会引起解剖结构的扭曲和皮质的代偿性功能重组，这可能导致白色物质束的标测不准确。为了克服这些问题，我们比较了不同的感兴趣区域（ROI）选择方案，以跟踪脑肿瘤患者的CST纤维。我们的研究调查了16例颅内肿瘤患者的CST。根据病变与初级运动皮质（PMC）/内囊的空间关系将患者分为3个亚组。具体而言，我们调查了导致肿瘤患者纤维束成像失真的关键因素。我们比较了使用不同ROI选择方案的3种CST纤维束成像方法。结果表明，CST纤维跟踪方法仅基于解剖ROI可能会导致附近的PMC区域的失真，可能无法有效地定位PMC。相比之下，双ROI方法，它使用的ROI，已经从血氧水平依赖性功能性MRI（BOLD-fMRI）激活和解剖标志选择，使纤维的运动皮层的跟踪。结果表明，双ROI方法可以定位整个CST纤维通路，并可以准确地描述CST纤维相对于肿瘤的空间关系。这些结果说明了在肿瘤患者中使用fMRI引导的DTT的可靠性。功能磁共振成像和解剖信息的结合增强了对具有解剖变形的脑中感兴趣的束的识别，这为神经外科医生提供了更准确的方法来可视化和定位脑肿瘤患者的白色纤维束。这种方法提高了手术性能并保护了大脑功能。
AbstractDiffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) techniques are widely used for identifying the corticospinal tract (CST) white matter pathways as part of presurgical planning. However, mass effects in patients with brain tumors tend to cause anatomical distortions and compensatory functional reorganization of the cortex, which may lead to inaccurate mapping of white matter tracts. To overcome these problems, we compared different region-of-interest (ROI) selection schemes to track CST fibers in patients with brain tumors. Our study investigated the CSTs of 16 patients with intracranial tumors. The patients were classified into 3 subgroups according to the spatial relationships of the lesion and the primary motor cortex (PMC)/internal capsule. Specifically, we investigated the key factors that cause distorted tractography in patients with tumors. We compared 3 CST tractography methods that used different ROI selection schemes. The results indicate that CST fiber tracking methods based only on anatomical ROIs could possibly lead to distortions near the PMC region and may be unable to effectively localize the PMC. In contrast, the dual ROI method, which uses ROIs that have been selected from both blood oxygen level-dependent functional MRI (BOLD-fMRI) activation and anatomical landmarks, enabled the tracking of fibers to the motor cortex. The results demonstrate that the dual ROI method can localize the entire CST fiber pathway and can accurately describe the spatial relationships of CST fibers relative to the tumor. These results illustrate the reliability of using fMRI-guided DTT in patients with tumors. The combination of fMRI and anatomical information enhances the identification of tracts of interest in brains with anatomical deformations, which provides neurosurgeons with a more accurate approach for visualizing and localizing white matter fiber tracts in patients with brain tumors. This approach enhances surgical performance and perserves brain function.