南方医科大学学报

南方医科大学学报 ›› 2006, Vol. 26 ›› Issue (11): 1648-1651.

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术前脑肿瘤患者脑白质束MR-DTI的初步研究

李贻卓； 黄子林； 魏大年； 谢传淼； 何浩强； 魏一飞； 陈林； 吴沛宏；   

  1. 华南肿瘤学国家重点实验室； 江西安远县人民医院放射科； 华南肿瘤学国家重点实验室 广东广州510060中山大学肿瘤医院影像介入科； 广东广州510060； 广东广州510060中山大学肿瘤医院影像介入科； 广东广州510060中山大学肿瘤医院神经外科； 江西安远342100；
  • 出版日期:2006-11-20 发布日期:2006-11-20

Diffusion tensor imaging of the white matter tracts in preoperative patients with cerebral neoplasm

LI Yi-zhuo1,2,HUANG Zi-lin1,2,WEI Da-nian1,3,XIE Chuan-miao1,2,HE Hao-qiang1,2,WEI Yi-fei4,CHEN Lin1,2,WU Pei-hong1,2 1State Key Laboratory of Oncology in South China,Guangzhou 510060,China;2Department of Imaging and Interventional Therapy,3Department of Neurosurgery,Tumor Hospital,Sun Yat-sen University,Guangzhou 510060,China;4Department of Radiology,People’s Hospital of Anyuan,Anyuan 342100,China   

  1. 华南肿瘤学国家重点实验室； 江西安远县人民医院放射科； 华南肿瘤学国家重点实验室 广东广州510060中山大学肿瘤医院影像介入科； 广东广州510060； 广东广州510060中山大学肿瘤医院影像介入科； 广东广州510060中山大学肿瘤医院神经外科； 江西安远342100；
  • Online:2006-11-20 Published:2006-11-20

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摘要： 目的利用MR-DTI技术行三维脑白质成像,评价脑肿瘤对白质束的改变,探讨脑肿瘤对白质的改变与瘤周部分各向异性值(FA值)改变的量化对应关系。方法12例脑内恶性肿瘤患者被成功地完成了常规MR检查及DTI检查,分别获得各自的常规MR图、相应感兴趣区(ROI)的部分各向异性图(FA图)、彩色编码张量图、脑白质三维示踪图、脑肿瘤侧和对侧内囊区的FA值。结果彩色编码张量图、三维示踪图可清楚地显示目标脑白质的位置,走行和受损状况。将患者患侧FA1值与对侧FA2值之比从0～1等分为4个区间,相应地将肿瘤致脑白质束的改变分为4种,Ⅰ:两侧FA值之比>75%,脑白质正常或基本正常;Ⅱ:FA值之比>50%,但<75%,脑白质移位或/和轻度受损;Ⅲ:FA值之比>25%,但<50%,脑白质中度受损但未完全破坏;Ⅳ:FA比值<25%,此时相应脑白质束未见显示。结论MR-DTI技术可进行脑白质纤维示踪,使其清晰地可视化。FA值的改变程度与脑白质纤维受损程度呈正相关。 

Abstract: Objective To evaluate the quantitative relationship between white matter tract(WMT) variation resulting from cerebral tumors and shifting of the fractional anisotropy(FA) index in magnetic resonance(MR) diffusion tensor imaging(DTI).Methods Four female and 8 male patients aged from 21 to 62 years with brain malignancies(2 malignant lymphomas,2 low-grade astrocytomas,and 8 high-grade cerebral gliomas) underwent conventional contrast-enhanced MR and DTI examinations before operation.Routine T2-weighted image,fractional anisotropic(FA) map,color-coded directional map,three-dimensional white matter tractography(WMT),and the FA index of bilateral internal capsule were obtained in every patient.Results Fiber tractography derived from DTI was consistent with known white matter fiber anatomy.The DTI patterns in WMT altered by the tumor were categorized on the basis of FA1/FA2 ratio as follows: pattern 1,FA1/FA2≥75% with normal or only slightly decreased FA;pattern 2,50%≤FA1/FA2<75% with WMT displacement;pattern 3,25%≤FA1/FA2<50% with WMT involvement;pattern 4,FA1/FA2<25% with WMT destruction.Conclusions DTI allows for visualization of WMT and benefits surgical planning for patients with intrinsic brain tumor.There is a positive relationship between the bilateral FA ratio(FA1/FA2) variation and WMT alterations resulting from the tumor. 

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