CAJ | 학술논문

目的探讨弥散张量成像(diffusion tensor imaging,DTI)在胶质瘤手术中对于保护神经功能的临床价值.方法 38例胶质瘤患者手术前后行DTI检查和神经功能评价.根据胶质瘤与其邻近部位白质纤维束的影像学关系DTI可以被分为三种类型:Ⅰ类-挤压型,Ⅱ类-浸润型,Ⅲ类-破坏型.三组患者之间术前神经功能状态的差异以及三组患者之间术后神经功能改变情况的差异分别进行比较.结果Ⅰ类-挤压型14例,Ⅱ类-浸润型16例,Ⅲ类-破坏型8例.不同DTI类型患者的术前神经功能状态之间以及小同DTI类型患者的术后神经功能改变情况之间的差异有统计学意义(P<0.05).结论 DTI能够显示胶质瘤与临近的白质纤维束之间的关系,体现了胶质瘤不同的生长方式,它能够帮助神经外科医生选择更加安全的手术入路和决定肿瘤切除程度.
목적 탐토미산장량성상(diffusion tensor imaging,DTI)재효질류수술중대우보호신경공능적림상개치.방법 38례효질류환자수술전후행DTI검사화신경공능평개.근거효질류여기린근부위백질섬유속적영상학관계DTI가이피분위삼충류형:Ⅰ류-제압형,Ⅱ류-침윤형,Ⅲ류-파배형.삼조환자지간술전신경공능상태적차이이급삼조환자지간술후신경공능개변정황적차이분별진행비교.결과Ⅰ류-제압형14례,Ⅱ류-침윤형16례,Ⅲ류-파배형8례.불동DTI류형환자적술전신경공능상태지간이급소동DTI류형환자적술후신경공능개변정황지간적차이유통계학의의(P<0.05).결론 DTI능구현시효질류여림근적백질섬유속지간적관계,체현료효질류불동적생장방식,타능구방조신경외과의생선택경가안전적수술입로화결정종류절제정도.
Objective To elucidate the clinical significance of diffusion tensor imaging (DTI) mainly used for protecting neurological functions in patients with gliomas. Methods Thirty - eight patients with gliomas were recruited to undergo DTI test and assess the status of neurological functions before and after surgery. According to the relationships between gliomas and adjacent white matter(WM) tracts, DTI can be classfied as the following types : type Ⅰ - displacement; type Ⅱ - Infiltration; type Ⅲ - Disruption. The neurological functions before surgery were compared in three groups,as well as the change of neurological functions after surgery was also compared in three groups. Results There were 14 cases in type Ⅰ , 16 cases in type Ⅱ, and 8 cases in type Ⅲ. There were significant difference between DTI types and preoperative neurological functions, as well as between DTI types and the change of postoperative neurological functions ( P < 0. 05 ). Conclusions DTI allows to visualizate the relationships of gliomas and adjacent WM tracts, which represent the different growth patterns of gliomas. It is useful for neurosurgeons to select suitable surgical approaches and determine appropriate extent of resection.