Evaluation On Individually Operative Risk And Curative Effect Of Gliomas By Magnetic Resonance Diffusion Tensor Imaging (MR-DTI)

Objective To elucidate the application value of diagnosis before surgery, grouping and grading correctly in gliomas, and the clinical significance of diffusion tensor imaging(DTI) mainly used for protecting neurological functions in patients with gliomas. Contents Collecting thirty-three patients with gliomas treated in people's hospital of Bai Autonomous Prefecture of Dali during September 2009 to March 2011. All cases were recruited to undergo conventional MRI test and MR-DTI test before surgery. According to the relationships between gliomas and adjacent white matter tracts, DTI can be divided into three types:typeâ… -displacement; typeâ…¡-infiltration; typeâ…¢-disruption; At the same time assessed cases'status of neurological functions, then compared gliomas'types and the status of neurological functions. According to gliomas'types, adopted different surgical strategy as follows: to strive for total excision to typeâ… -displacement; adopt subtotal excision or partial resection to typeâ…¡-infiltration; to enlarge the scope of excision properly. After surgery assessed the status of neurological functions and recheck MR-DTI test promptly, compared gliomas'types and postoperative status of neurological functions; then compared cases'status of neurological functions before and after surgery. Methods Thirty-three patients with gliomas were recruited to undergo MR-DTI test and the status of neurosurgical functions before and after surgery. According to the result of MR-DTI test, the relationships of gliomas and adjacent white matter tracts can be classified as the following types:typeâ… -displacement; typeâ…¡-infiltration; typeâ…¢-disruption. The neurological functions before surgery were compared in three groups, as well as the change of neurological functions after surgery was compared in three groups, and the change of neurological functions before and after surgery was also compared in three groups. Results According to the result of MR-DTI test, the relationships of gliomas and adjacent white matter tracts can be classified as the three types:typeâ… -displacement; typeâ…¡-infiltration; typeâ…¢-disruption. There were 12 cases in typeâ… . There were 12 cases in typeâ…¡. There were 9 cases in type III.1. There were significant differences between gliomas'FA values and relative normal brain tissue's in each type (p<0.05).2. There were significant difference between MR-DTI types and preoperative neurological functions, as well as between MR-DTI types and the change of postoperative neurological functions (p<0.05).3. There were significant differences in the states of neurological functions before and after surgery. Conclusions MR-DTI can be used for showing the relationships of gliomas and adjacent white matter 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.