中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2012年
6期
626-629
,共4页
赵琳%王守森%黄银兴%周晓平
趙琳%王守森%黃銀興%週曉平
조림%왕수삼%황은흥%주효평
脑肿瘤%皮质运动区%磁共振弥散张量成像
腦腫瘤%皮質運動區%磁共振瀰散張量成像
뇌종류%피질운동구%자공진미산장량성상
Brain tumor,Cortical motor area%Magnetic resonance diffusion tensor imaging
目的 探讨磁共振(MRI)弥散张量成像(DTI)对脑皮质运动区肿瘤患者偏瘫肢体术后运动功能的评估价值. 方法 南京军区福州总医院神经外科自2009年3月至2011年1月共收治脑皮质运动区肿瘤患者20例,手术前后均行DTI检查并应用Brunnstrom评分法评价偏瘫肢体 的运动功能,根据DTI结果将皮质脊髓束(CST)的受损级别分为4级:1级(CST完整)；2级(CST完整,但轻度受压推移);3级(CST部分中断)；4级(CST大部分至完全中断),比较患者手术前后CST受损级别和偏瘫肢体的运动功能,分析二者的相关性. 结果 患者患侧肿瘤实质的FA值(0.387±0.012)小于对侧正常脑组织的FA值(0.498±0.015),差异有统计学意义(P＜0.05)；患者手术前后CST受损级别、偏瘫肢体运动功能的比较差异无统计学意义(P＞0.05)；患者术前、术后6个月CST的受损级别与偏瘫肢体的运动功能均呈负相关(r=-0.901,P=0.000; r=-0.912,P=0.000). 结论 DT1能够显示脑皮质运动区肿瘤患者CST的损伤程度,反映患者术后偏瘫肢体的运动功能.
目的 探討磁共振(MRI)瀰散張量成像(DTI)對腦皮質運動區腫瘤患者偏癱肢體術後運動功能的評估價值. 方法 南京軍區福州總醫院神經外科自2009年3月至2011年1月共收治腦皮質運動區腫瘤患者20例,手術前後均行DTI檢查併應用Brunnstrom評分法評價偏癱肢體 的運動功能,根據DTI結果將皮質脊髓束(CST)的受損級彆分為4級:1級(CST完整)；2級(CST完整,但輕度受壓推移);3級(CST部分中斷)；4級(CST大部分至完全中斷),比較患者手術前後CST受損級彆和偏癱肢體的運動功能,分析二者的相關性. 結果 患者患側腫瘤實質的FA值(0.387±0.012)小于對側正常腦組織的FA值(0.498±0.015),差異有統計學意義(P＜0.05)；患者手術前後CST受損級彆、偏癱肢體運動功能的比較差異無統計學意義(P＞0.05)；患者術前、術後6箇月CST的受損級彆與偏癱肢體的運動功能均呈負相關(r=-0.901,P=0.000; r=-0.912,P=0.000). 結論 DT1能夠顯示腦皮質運動區腫瘤患者CST的損傷程度,反映患者術後偏癱肢體的運動功能.
목적 탐토자공진(MRI)미산장량성상(DTI)대뇌피질운동구종류환자편탄지체술후운동공능적평고개치. 방법 남경군구복주총의원신경외과자2009년3월지2011년1월공수치뇌피질운동구종류환자20례,수술전후균행DTI검사병응용Brunnstrom평분법평개편탄지체 적운동공능,근거DTI결과장피질척수속(CST)적수손급별분위4급:1급(CST완정)；2급(CST완정,단경도수압추이);3급(CST부분중단)；4급(CST대부분지완전중단),비교환자수술전후CST수손급별화편탄지체적운동공능,분석이자적상관성. 결과 환자환측종류실질적FA치(0.387±0.012)소우대측정상뇌조직적FA치(0.498±0.015),차이유통계학의의(P＜0.05)；환자수술전후CST수손급별、편탄지체운동공능적비교차이무통계학의의(P＞0.05)；환자술전、술후6개월CST적수손급별여편탄지체적운동공능균정부상관(r=-0.901,P=0.000; r=-0.912,P=0.000). 결론 DT1능구현시뇌피질운동구종류환자CST적손상정도,반영환자술후편탄지체적운동공능.
Objective To discuss the predictive value of magnetic resonance diffusion tensor imaging (MR-DTI) in motor function of patients with tumors in the motor areas of cerebral cortex after surgery on the hemiplegic limbs. Methods Twenty patients with tumors in the motor areas of cerebral cortex,admitted to our hospital from March 2009 to January 2011,were recruited in our study; all these patients underwent MR-DTI and motor function of the hemiplegic limbs was evaluated with Brunnstrom scale before and after the surgery.According to the results of DTI test,the injured corticospinal tract (CST) was divided into 4 grades:type Ⅰ (CST integrity),type Ⅱ (CST integrity with mild compression),type Ⅲ (CST partial disruption) and type Ⅳ (CST mostly/completely disruption).The correlations between the CST damaged level and motor function of the hemiplegic limbs before and after surgery were analyzed. Results FA values ofipsilateral brain parenchyma (0.387±0.012) were statistically lower than those of the contralateral normal brain tissue (0.498±0.015,P＜0.05).No significant differences on CST damaged level and motor function of the hemiplegic limbs were noted between before and after surgery (P＞0.05).CST damaged level and motor function of the hemiplegic limbs had a negative correlation (P＜0.05).Motor function of the hemiplegic limbs and CST damaged level before the surgery and 6 months after the surgery had a significantly negative correlation (before the surgery:r=-0.901,P=0.000; after the surgery:r=-0.912,P=0.000). Conclusion DTI can display damaged level of the tumors in the motor area of cerebral cortex and reflect the motor function of the hemiplegic limbs after the surgery.
