目的:确定弥散张量成像(DTI)参数和局部脑血流量(rCBF)是否在术前预测脑肿瘤患者术后运动结果。
方法:我们纳入了81例接受手术治疗的脑肿瘤患者。入院和出院时使用上肢和下肢的手动肌肉测试评估运动功能。分数各向异性(FA),平均扩散率(MD),轴向扩散率(AD),径向扩散系数(RD),和它们的比率(rFA,rMD,rAD,和rRD)在电晕辐射下测量,内囊,和皮质脊髓束(CST)的脑梗。此外,合成DTI和单光子发射计算机断层扫描(SPECT)以测量CST的rCBF。
结果:术前运动无力组CST的DTI参数和rCBF与术前功能正常组显著不同。术后运动恢复者的脑梗和内囊的rFA明显高于术后无变化或运动功能恶化者(P<0.05)。此外,运动恢复组内囊rMD和rRD明显降低(P<0.05,P<0.01)。此外,所有脑花梗的rCBF都较高,内囊,运动恢复组的电晕辐射高于运动功能不变和恶化组(P<0.05,P<0.01,P<0.01)。
结论:DTI参数和rCBF的分析有助于预测脑肿瘤患者术后的运动结果。
OBJECTIVE: To determine whether diffusion tensor image (DTI) parameters and regional cerebral blood flow (rCBF) serve to preoperatively predict postoperative motor outcomes in patients with brain tumors.
METHODS: We included 81 patients with brain tumors who underwent surgical treatment. Motor function was assessed using the manual muscle test in the upper and lower limbs at admission and discharge. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and their ratios (rFA, rMD, rAD, and rRD) were measured at the corona radiata, internal capsule, and cerebral peduncle of the corticospinal tract (CST). In addition, DTI and single photon emission computed tomography (SPECT) were synthesized to measure rCBF at the CST.
RESULTS: Both DTI parameters and rCBF at the CST in the preoperative motor weakness group significantly differed from those of the preoperative normal function group. rFA at the cerebral peduncle and the internal capsule was considerably higher in those showing postoperative motor recovery than in those postoperative unchanged or with deteriorated motor function (P < 0.05). Moreover, there was significantly lower rMD and rRD at the internal capsule in the motor recovery group (P < 0.05, P < 0.01). Furthermore, rCBF was higher at all the cerebral peduncle, internal capsule, and corona radiate in the motor recovery group than in the unchanged and deteriorated motor function group (P < 0.05, P < 0.01, P < 0.01).
CONCLUSIONS: The analysis of DTI parameters and rCBF is useful in predicting postoperative motor outcomes in patients with brain tumors.